Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease
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...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-05904-3 |
| _version_ | 1818622820846927872 |
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| author | Regina E. Abotsi Mark P. Nicol Grace McHugh Victoria Simms Andrea M. Rehman Charmaine Barthus Slindile Mbhele Brewster W. Moyo Lucky G. Ngwira Hilda Mujuru Beauty Makamure Justin Mayini Jon Ø. Odland Rashida A. Ferrand Felix S. Dube |
| author_facet | Regina E. Abotsi Mark P. Nicol Grace McHugh Victoria Simms Andrea M. Rehman Charmaine Barthus Slindile Mbhele Brewster W. Moyo Lucky G. Ngwira Hilda Mujuru Beauty Makamure Justin Mayini Jon Ø. Odland Rashida A. Ferrand Felix S. Dube |
| author_sort | Regina E. Abotsi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-16T18:31:15Z |
| format | Article |
| id | doaj.art-8eaea3006f434a2ba36b9fd84dd8cfa8 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-16T18:31:15Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-8eaea3006f434a2ba36b9fd84dd8cfa82022-12-21T22:21:17ZengBMCBMC Infectious Diseases1471-23342021-02-0121111710.1186/s12879-021-05904-3Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung diseaseRegina E. Abotsi0Mark P. Nicol1Grace McHugh2Victoria Simms3Andrea M. Rehman4Charmaine Barthus5Slindile Mbhele6Brewster W. Moyo7Lucky G. Ngwira8Hilda Mujuru9Beauty Makamure10Justin Mayini11Jon Ø. Odland12Rashida A. Ferrand13Felix S. Dube14Department of Molecular and Cell Biology & Institute of Infectious Diseases and Molecular Medicine, University of Cape TownDivision of Infection and Immunity, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Western AustraliaBiomedical Research and Training InstituteMRC International Statistics & Epidemiology Group, London School of Hygiene and Tropical MedicineMRC International Statistics & Epidemiology Group, London School of Hygiene and Tropical MedicineDivision of Medical Microbiology, University of Cape TownDivision of Medical Microbiology, University of Cape TownMalawi-Liverpool Wellcome Trust Clinical Research ProgrammeMalawi-Liverpool Wellcome Trust Clinical Research ProgrammeDepartment of Paediatrics, University of ZimbabweBiomedical Research and Training InstituteBiomedical Research and Training InstituteDepartment of Community Medicine, University of TromsøBiomedical Research and Training InstituteDepartment of Molecular and Cell Biology & Institute of Infectious Diseases and Molecular Medicine, University of Cape TownAbstract 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.https://doi.org/10.1186/s12879-021-05904-3Streptococcus pneumoniaeStaphylococcus aureusMoraxella catarrhalisHaemophilus influenzaeAntibiotic resistanceChildren |
| spellingShingle | Regina E. Abotsi Mark P. Nicol Grace McHugh Victoria Simms Andrea M. Rehman Charmaine Barthus Slindile Mbhele Brewster W. Moyo Lucky G. Ngwira Hilda Mujuru Beauty Makamure Justin Mayini Jon Ø. Odland Rashida A. Ferrand Felix S. Dube Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease BMC Infectious Diseases Streptococcus pneumoniae Staphylococcus aureus Moraxella catarrhalis Haemophilus influenzae Antibiotic resistance Children |
| title | Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease |
| title_full | Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease |
| title_fullStr | Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease |
| title_full_unstemmed | Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease |
| title_short | Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease |
| title_sort | prevalence and antimicrobial resistance profiles of respiratory microbial flora in african children with hiv associated chronic lung disease |
| topic | Streptococcus pneumoniae Staphylococcus aureus Moraxella catarrhalis Haemophilus influenzae Antibiotic resistance Children |
| url | https://doi.org/10.1186/s12879-021-05904-3 |
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