Antimicrobial Sensitivity Patterns Of Urogenital Bacterial Isolates Among Hiv Positive Patients In The Federal Medical Centre In Gombe

摘要

Apart from the risk of increasing the concentration of HIV infection in genital secretions, consequences of sexually transmitted infections (STI) can be grave, resulting in conditions such as infertility, ectopic pregnancy, cancer and neonatal infections. Urogenital tract swab samples including urethral swabs (URS), endocervical swabs (ECS) and high vaginal swabs (HVS) were aseptically collected from 158 HIV positive individuals presented with symptoms of urogenital tract infections at federal medical centre, Gombe between May to September, 2009. These were subjected to microscopy, culture and sensitivity testing (using Abtec? sensitivity discs). Out of the samples, 30 (18.9%) produced bacterial growth. In the male category, highest percentage of bacteria isolated was in the age group 11-20yrs (20.0%), while in the female category, it was in the age group 41-50yrs (25.0%). No bacteria isolated at age ≥51yrs in both sexes. Six opportunistic bacterial species were isolated of which Staphylococcus aureus had the highest frequency of 9 (30.0%) while Enterococcus faecalis had the lowest as 1(3.3%). The most active drug against S. aureus observed was augmentin (71.4%). Two exogenous bacterial species were also isolated; Neisseria gonorrhea which was resistant to tetracycline and Haemophilus species which was sensitive to all but cotrimotazole and fusidin. This work recommended the need for the hospitals to improve in partner notification and treatment, early and correct diagnosis to the patients and use of augmentin, gentimicin and sparfloxacin in symptomatic treatment, where laboratory investigations are not available. Introduction Pathogenic bacterial isolates of urogenital tract (UGT) are among sexually transmitted infections (STI) that have a significant probability of transmission between humans or animals by means of sexual contact, especially during vaginal, oral or anal sex. (1). Urogenital tract bacterial infections may be divided into two main categories; infections due to opportunistic (endogenously acquired) bacteria such as Staphylococcus aureus or, Escherichia coli. These are the most common cause of urogenital tract diseases, (2) and infections due to exogenously acquired bacteria e.g. Treponema pallidum and Neisseria gonorrhea, (3). Although most of UGT pathogenic bacteria are treatable, however, even the once easily cured have now become resistant to many of the older traditional antibiotics. (4). In antimicrobial therapy of these infections, it is equally clear however that host response are at least as important as are the antibiotics in determining the outcome of an infection. The recent emergence of HIV/AIDS has provided an ample evidence of the importance of host defence in protecting infection as the high mortality due to AIDS is almost entirely attributed to opportunistic infections, hence the need for a very special management of the opportunistic infections. The synergistic relationship between STI and HIV is well recognized. In Africa, transmission of the virus takes place mainly through heterosexual intercourse (5). Studies have shown that STI increase concentration of HIV in genital secretions (6) and thus improved clinical management of STI significantly reduces the incidence of HIV infection in developing countries (7). In Nigeria, the median prevalence of HIV among STI patients was found to be 11.5% (8). Apart from the risk of acquiring HIV infection, consequences of STI can be grave resulting in conditions such as infertility, ectopic pregnancy, cancer, neonatal infections and even death (9). Although STI are common to both sexes and all ages in any community, certain risk factors abound for acquiring the diseases, e.g. younger age (15-39 years), having more than one sexual partner and irregular use of condoms (10). Materials And Methods Study site/group The study was conducted between May and September, 2009 in Federal Medical Centre Gombe, a tertiary health institution located within the city of Go