Abstract
Lower respiratory tract infections (LRTIs) are the most frequent respiratory diseases among HIV infected patients and are frequently the first clinical manifestations of the HIV infections. LRTIs are common not only among the HIV seropositive cases but also the commonest domiciliary and nosocomial infections among the general population. The present study was carried out to determine the comparative prevalence of common bacterial and fungal organism among the HIV positive and control population. This cross sectional study was conducted among 220 people attending National Public Health Laboratory, Kathmandu, Nepal. Out of them 120 were HIV sero-positive and rest were HIV sero-negative. Sputum samples were collected and processed soon after its collection. Macroscopic examination was done to determine the sample integrity. Gram stain, AFB stain and KOH preparation was performed for preliminary identification of the pathogens. Culture was carried out for bacterial and fungal pathogens. Antibiotic susceptibility test (Kirby–Bauer disc diffusion method) was performed from the isolated organisms. The 85 out of 120 HIV sero-positive patients were found to be infected with one or more microbial pathogens. The overall infection rate was found to be significantly lower in HIV seronegative people (27 %). Among HIV seropositive cases prevalence of LRTIs was strongly associated with lower CD4 counts (<200/mm3). The prevalence of mycobacterium tuberculosis was found to be 10 % among HIV/AIDS patients which was significantly higher than among the non-HIV cases (3 %). The bacterial pathogens was observed among 46.6 % of HIV positive and 22.0 % of HIV negative people. Among the positive cases, K. pneumoniae was the predominant bacterial pathogens, followed by E. coli and S. pneumoniae. C. albicans was found to be predominant fungal pathogen followed by Aspergillus spp. germ tube negative Candida spp. and Penicillium spp. Similar types of organisms were found to be associated with LRTIs among HIV positive and negative people. The prevalence of both fungal and bacterial infections was significantly higher among HIV seropositive people than HIV seronegative people. All in all, lower respiratory tract illness is significantly higher in HIV/AIDS cases than in HIV seronegative cases.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ayyagari A, Sharma AK, Prasad KN. Spectrum of opportunistic infections in human immunodeficiency virus (HIV) infected cases in a tertiary care hospital. Indian J Med Microbiol. 1999;17:78–80.
Forbes BA, Sahm DF, Weissfeld AS. Bailey and Scott’s diagnostic microbiology. 11th ed. St. Louis: Mosby; 2002. p. 884–98.
Henry DI. Clinical microbiology procedures. Handbook. 2nd ed. Washington, DC: ASM; 2004.
Hirschtick RE, Glassroth J, Jordan MC. Bacterial pneumonia in persons infected with the human immunodeficiency virus. N Engl J Med. 1995;333:845–51.
Khan PA, Malik A, Fatima N, Shameem M. Profile of fungal lower respiratory tract infections and CD4 counts in HIV positive patients. Virol Mycol. 2013;2:113.
Mayaud C, Parrot A, Cadranel J. Pyogenic bacterial lower respiratory tract infection in human immunodeficiency virus-infected patients. Eur Respir J. 2002;20(Suppl. 36):28s–39s.
McEllistrem MC, Mendelsohn AB, Pass MA. Recurrent invasive pneumococcal disease in individuals with human immunodeficiency virus infection. J Infect Dis. 2002;185:1364–8.
Meyer CN, Skinhoj P, Prag J. Bacteremia in HIV-positive and AIDS patients: incidence, species distribution, risk factors, outcome, and influence of long-term prophylactic antibiotic treatment. Scand J Infect Dis. 1994;26:635–42.
Mishra SK, Kattel HP, Acharya J, Shah NP, Shah AS, Sherchand JB, Rijal BP, Pokhrel BM. Recent trend of bacterial aetiology of lower respiratory tract infections in a tertiary care centre of Nepal. Int J Infect Microbiol. 2012;1(1):3–8.
Rimland D, Navin TR, Lennox JL. Prospective study of etiologic agents of community-acquired pneumonia in patients with HIV infection. AIDS. 2002;16:2361–2.
Rosen MJ. Pneumonia in patients with HIV infection. Med Clin N Am. 1994;78:1067–78.
Salomon N, Gomez T, Perlman DC, Laya L, Eber C, Mildvan D. Clinical features and outcomes of HIV-related cytomegalovirus pneumonia. AIDS. 1997;11:319–24.
Shailaja VV, Pai LA, Mathur DR, Lakshmi V. Prevalence of bacterial and fungal agents causing lower respiratory tract infections in patients with HIV infection. Indian J Med Microbiol. 2004;22(1):28–33.
Tamang MD, Dev S, Makaju RK, Jha BK, Shivananda PG, Bhramadatan KN. Prevalence of Moraxella catarrhalis infections of the lower respiratory tract in elderly patient. Kathmandu Univ Med J. 2005;3(1):39–44.
WHO (2005) Global TB control, surveillance, planning, financing; communicable diseases.
Acknowledgments
The authors would like to thanks the technical staff of National public health laboratory for its contribution to this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ojha, C.R., Rijal, N., Khagendra, K.C. et al. Lower respiratory tract infections among HIV positive and control group in Nepal. VirusDis. 26, 77–81 (2015). https://doi.org/10.1007/s13337-015-0254-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13337-015-0254-z