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

dc.contributor.authorAbotsi, Regina E
dc.contributor.authorNicol, Mark P
dc.contributor.authorMcHugh, Grace
dc.contributor.authorSimms, Victoria
dc.contributor.authorRehman, Andrea M
dc.contributor.authorBarthus, Charmaine
dc.contributor.authorMbhele, Slindile
dc.contributor.authorMoyo, Brewster W
dc.contributor.authorNgwira, Lucky G
dc.contributor.authorMujuru, Hilda
dc.contributor.authorMakamure, Beauty
dc.contributor.authorMayini, Justin
dc.contributor.authorOdland, Jon Ø
dc.contributor.authorFerrand, Rashida A
dc.contributor.authorDube, Felix S
dc.date.accessioned2021-10-12T04:57:06Z
dc.date.available2021-10-12T04:57:06Z
dc.date.issued2021-02-25
dc.date.updated2021-02-28T04:18:30Z
dc.description.abstractBackground 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.en_US
dc.identifier.apacitationAbotsi, R. E., Nicol, M. P., McHugh, G., Simms, V., Rehman, A. M., Barthus, C., ... Dube, F. S. (2021). Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease. <i>BMC Infectious Diseases</i>, 21(Article number: 216), http://hdl.handle.net/11427/35171en_ZA
dc.identifier.chicagocitationAbotsi, Regina E, Mark P Nicol, Grace McHugh, Victoria Simms, Andrea M Rehman, Charmaine Barthus, Slindile Mbhele, et al "Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease." <i>BMC Infectious Diseases</i> 21, Article number: 216. (2021) http://hdl.handle.net/11427/35171en_ZA
dc.identifier.citationAbotsi, R.E., Nicol, M.P., McHugh, G., Simms, V., Rehman, A.M., Barthus, C., Mbhele, S. & Moyo, B.W. et al. 2021. Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease. <i>BMC Infectious Diseases.</i> 21(Article number: 216) http://hdl.handle.net/11427/35171en_ZA
dc.identifier.ris TY - Journal Article AU - Abotsi, Regina E AU - Nicol, Mark P AU - McHugh, Grace AU - Simms, Victoria AU - Rehman, Andrea M AU - Barthus, Charmaine AU - Mbhele, Slindile AU - Moyo, Brewster W AU - Ngwira, Lucky G AU - Mujuru, Hilda AU - Makamure, Beauty AU - Mayini, Justin AU - Odland, Jon Ø AU - Ferrand, Rashida A AU - Dube, Felix S AB - 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. DA - 2021-02-25 DB - OpenUCT DP - University of Cape Town IS - Article number: 216 J1 - BMC Infectious Diseases KW - Streptococcus pneumoniae KW - Staphylococcus aureus KW - Moraxella catarrhalis KW - Haemophilus influenzae KW - Antibiotic resistance KW - Children KW - HIV KW - Chronic lung disease LK - https://open.uct.ac.za PY - 2021 T1 - Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease TI - Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease UR - http://hdl.handle.net/11427/35171 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12879-021-05904-3
dc.identifier.urihttp://hdl.handle.net/11427/35171
dc.identifier.vancouvercitationAbotsi RE, Nicol MP, McHugh G, Simms V, Rehman AM, Barthus C, et al. Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease. BMC Infectious Diseases. 2021;21(Article number: 216) http://hdl.handle.net/11427/35171.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDepartment of Molecular and Cell Biologyen_US
dc.publisher.facultyFaculty of Scienceen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Infectious Diseasesen_US
dc.source.journalissueArticle number: 216en_US
dc.source.journalvolume21en_US
dc.source.urihttps://bmcinfectdis.biomedcentral.com/
dc.subjectStreptococcus pneumoniaeen_US
dc.subjectStaphylococcus aureusen_US
dc.subjectMoraxella catarrhalisen_US
dc.subjectHaemophilus influenzaeen_US
dc.subjectAntibiotic resistanceen_US
dc.subjectChildrenen_US
dc.subjectHIVen_US
dc.subjectChronic lung diseaseen_US
dc.titlePrevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung diseaseen_US
dc.typeJournal Articleen_US
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