ub.xmlui.mirage2.page-structure.muninLogoub.xmlui.mirage2.page-structure.openResearchArchiveLogo
    • EnglishEnglish
    • norsknorsk
  • Velg spraakEnglish 
    • EnglishEnglish
    • norsknorsk
  • Administration/UB
View Item 
  •   Home
  • Det helsevitenskapelige fakultet
  • Institutt for samfunnsmedisin
  • Artikler, rapporter og annet (samfunnsmedisin)
  • View Item
  •   Home
  • Det helsevitenskapelige fakultet
  • Institutt for samfunnsmedisin
  • Artikler, rapporter og annet (samfunnsmedisin)
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease

Permanent link
https://hdl.handle.net/10037/23965
DOI
https://doi.org/10.1186/s12879-021-05904-3
Thumbnail
View/Open
article.pdf (698.7Kb)
Published version (PDF)
Date
2021-02-25
Type
Journal article
Tidsskriftartikkel
Peer reviewed

Author
Abotsi, Regina E.; Nicol, Mark P.; McHugh, Grace; Simms, Victoria; Rehman, Andrea M.; Barthus, Charmaine; Mbhele, Slindile; Moyo, Brewster Wisdom; Ngwira, Lucky Gift; Mujuru, Hilda A.; Makamure, Beauty; Mayini, Justin; Odland, Jon Øyvind; Ferrand, Rashida A.; Dube, Felix S.
Abstract
Background HIV-associated chronic lung disease (CLD) is common among children living with HIV (CLWH) in sub-Saharan Africa, including those on antiretroviral therapy (ART). However, the pathogenesis of CLD and its possible association with microbial determinants remain poorly understood. We investigated the prevalence, and antibiotic susceptibility of Streptococcus pneumoniae (SP), Staphylococcus aureus (SA), Haemophilus influenzae (HI), and Moraxella catarrhalis (MC) among CLWH (established on ART) who had CLD (CLD+), or not (CLD-) in Zimbabwe and Malawi.


Methods Nasopharyngeal swabs (NP) and sputa were collected from CLD+ CLWH (defined as forced-expiratory volume per second z-score < − 1 without reversibility post-bronchodilation with salbutamol), at enrolment as part of a randomised, placebo-controlled trial of azithromycin (BREATHE trial - NCT02426112), and from age- and sex-matched CLD- CLWH. Samples were cultured, and antibiotic susceptibility testing was conducted using disk diffusion. Risk factors for bacterial carriage were identified using questionnaires and analysed using multivariate logistic regression.


Results A total of 410 participants (336 CLD+, 74 CLD-) were enrolled (median age, 15 years [IQR = 13–18]). SP and MC carriage in NP were higher in CLD+ than in CLD- children: 46% (154/336) vs. 26% (19/74), p = 0.008; and 14% (49/336) vs. 3% (2/74), p = 0.012, respectively. SP isolates from the NP of CLD+ children were more likely to be non-susceptible to penicillin than those from CLD- children (36% [53/144] vs 11% [2/18], p = 0.036). Methicillin-resistant SA was uncommon [4% (7/195)]. In multivariate analysis, key factors associated with NP bacterial carriage included having CLD (SP: adjusted odds ratio (aOR) 2 [95% CI 1.1–3.9]), younger age (SP: aOR 3.2 [1.8–5.8]), viral load suppression (SP: aOR 0.6 [0.4–1.0], SA: 0.5 [0.3–0.9]), stunting (SP: aOR 1.6 [1.1–2.6]) and male sex (SA: aOR 1.7 [1.0–2.9]). Sputum bacterial carriage was similar in both groups (50%) and was associated with Zimbabwean site (SP: aOR 3.1 [1.4–7.3], SA: 2.1 [1.1–4.2]), being on ART for a longer period (SP: aOR 0.3 [0.1–0.8]), and hot compared to rainy season (SP: aOR 2.3 [1.2–4.4]).


Conclusions CLD+ CLWH were more likely to be colonised by MC and SP, including penicillin-non-susceptible SP strains, than CLD- CLWH. The role of these bacteria in CLD pathogenesis, including the risk of acute exacerbations, should be further studied.

Publisher
BMC
Citation
Abotsi, Nicol, McHugh, Simms, Rehman, Barthus, Mbhele, Moyo, Ngwira, Mujuru, Makamure, Mayini, Odland, Ferrand, Dube. Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease. BMC Infectious Diseases. 2021;21(1)
Metadata
Show full item record
Collections
  • Artikler, rapporter og annet (samfunnsmedisin) [1515]
Copyright 2021 The Author(s)

Browse

Browse all of MuninCommunities & CollectionsAuthor listTitlesBy Issue DateBrowse this CollectionAuthor listTitlesBy Issue Date
Login

Statistics

View Usage Statistics
UiT

Munin is powered by DSpace

UiT The Arctic University of Norway
The University Library
uit.no/ub - munin@ub.uit.no

Accessibility statement (Norwegian only)