Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease
dc.contributor.author | Abotsi, Regina E | |
dc.contributor.author | Nicol, Mark P | |
dc.contributor.author | McHugh, Grace | |
dc.contributor.author | Simms, Victoria | |
dc.contributor.author | Rehman, Andrea M | |
dc.contributor.author | Barthus, Charmaine | |
dc.contributor.author | Mbhele, Slindile | |
dc.contributor.author | Moyo, Brewster W | |
dc.contributor.author | Ngwira, Lucky G | |
dc.contributor.author | Mujuru, Hilda | |
dc.contributor.author | Makamure, Beauty | |
dc.contributor.author | Mayini, Justin | |
dc.contributor.author | Odland, Jon Ø | |
dc.contributor.author | Ferrand, Rashida A | |
dc.contributor.author | Dube, Felix S | |
dc.date.accessioned | 2021-10-12T04:57:06Z | |
dc.date.available | 2021-10-12T04:57:06Z | |
dc.date.issued | 2021-02-25 | |
dc.date.updated | 2021-02-28T04:18:30Z | |
dc.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. | en_US |
dc.identifier.apacitation | Abotsi, 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/11427/35171 | en_ZA |
dc.identifier.chicagocitation | Abotsi, 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/11427/35171 | en_ZA |
dc.identifier.citation | Abotsi, 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/11427/35171 | en_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.uri | https://doi.org/10.1186/s12879-021-05904-3 | |
dc.identifier.uri | http://hdl.handle.net/11427/35171 | |
dc.identifier.vancouvercitation | Abotsi 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.iso | en | en_US |
dc.language.rfc3066 | en | |
dc.publisher.department | Department of Molecular and Cell Biology | en_US |
dc.publisher.faculty | Faculty of Science | en_US |
dc.rights.holder | The Author(s) | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | en_US |
dc.source | BMC Infectious Diseases | en_US |
dc.source.journalissue | Article number: 216 | en_US |
dc.source.journalvolume | 21 | en_US |
dc.source.uri | https://bmcinfectdis.biomedcentral.com/ | |
dc.subject | Streptococcus pneumoniae | en_US |
dc.subject | Staphylococcus aureus | en_US |
dc.subject | Moraxella catarrhalis | en_US |
dc.subject | Haemophilus influenzae | en_US |
dc.subject | Antibiotic resistance | en_US |
dc.subject | Children | en_US |
dc.subject | HIV | en_US |
dc.subject | Chronic lung disease | en_US |
dc.title | Prevalence and antimicrobial resistance profiles of respiratory microbial flora in African children with HIV-associated chronic lung disease | en_US |
dc.type | Journal Article | en_US |