Emergence of multidrug resistant bacterial infection in HIV/AIDS cases

Background: Multidrug resistant (MDR) bacterial infections are an important cause of life threatening illnesses associated with the HIV/AIDS patients that require rapid and aggressive antimicrobial treatment. The present study was conducted to examine the organisms and the resistance pattern of the bacterial isolates from the HIV/AIDS cases.Methods: Bacteria isolated from the clinical specimen of HIV/AIDS cases with suspected bacterial infection during the period from March 2009 to April 2010 were included in the study. Antimicrobial susceptibility testing was performed using Kirby Bauer’s disc diffusion method according to Clinical Laboratory Standards Institute (CLSI) guidelines. Methicillin resistant (MR) Staphylococci and extended spectrum β-lactamase (ESBL) production were tested by disc diffusion methods; Inducible AmpC β-lactamase by using Imipenem and Metallo-β-lactamase (MBL) production by using Imipenem + ethylene diamine tetra-acitic acid (EDTA) disk diffusion method.Results: Out of the 21 bacterial isolates included in the study, 4 were MR-Staphylococci, 17 were gram negative bacilli (GNB) of which 11(64.7%) were β-lactamases producer (ESBL-8; AmpC-1; MBL-2) as examined phenotypically. E. coli was observed to be the most common bacterial isolates. Out of the total isolates 81.1% were observed to be MDR. Methicillin resistant Staphylococci shows highly sensitive against Vancomycin and Linezolid and all the GNB were sensitive against Imipenem except for MBL producer E. coli which shows sensitive, one strain against Chloramphenicol and another strain against Ciprofloxacin.Conclusions: Bacterial infection to the HIV infected cases were mostly by the MDR bacteria. Thus suggesting that empiric antibiotic treatment should be adopted and the clinicians caring such immunocompromised patients should be aware of the most common bacteria and their local antibiogram to provide empirical therapy for the serious bacterial infection.