Lower Respiratory Tract Infection (LRTI) is associated with mortality and prolonged antibiotics use among HIV/AIDS patients. Sputum samples were collected from 134 HIV/AIDS patients with LRTI and productive cough, visiting University of Abuja Teaching Hospital, Nigeria, to determine the bacterial aetiologies and antibiotic resistance profile. Adequate for culture sputum samples were observed in only 119 subjects (75 females and 44 males) and cultured using standard procedure. Isolates were identified by biochemical method and 16SrRNA gene amplification, purification, sequencing and database nucleotide blast. Antibiotic susceptibility tests were performed and interpreted according to Clinical and Laboratory Standard Institute (CLSI) procedures. Bacteria associated LRTI was found in 20.2% of the patients and Klebsiella pneumonia (29.7%); Enterobacter cloacae (16.7%); Enterobacter hormaechei subsp. xiangfangensis (12.5%); Pseudomonas parafulva; Pseudomonas aeruginosa; Pseudomonas alcaliphila; Klebsiella aerogenes (8.3%); Comamonas testosteroni; Escherichia coli; Acinetobacter junii; Acinetobacter soli and Acinetobacter baumannii were implicated. Isolates show high resistance to amoxicillin-clavulanic acid at 94.1%, trimethoprim-sulfamethoxazole at 75.0% and cefotaxime at 70.0%. The Multiple Antibiotic Resistance (MAR) index of most isolates (62.5%) is within 0.3-0.8 in a range of 0.0 to 0.8. Isolates of the same species were found to have different MAR index in different patients. However, E. cloacae, E. hormaechei subsp. xiangfangensis, A. baumanni and 71.4% of K. pneumonia were Multi-drug Resistant (MDR). Interestingly, Gentamycin, Ciprofloxacin and Imipenem were effective against MDR isolates and showed significant negative correlation with MAR index. We propose that antibiotics with efficacy against MDR isolates could be used to down regulate the selective pressure of other antibiotics, and these MDR pathogens, including those rarely associated with human infection poses potential threat, similar to Methicillin Resistant Staphylococcus aureus (MRSA). Particularly, among the immunocompromised. Furthermore, HIV/AIDS patients present good metrics for profiling the burden and spread of antibiotic resistant bacteria in poor countries.

中文翻译：

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尼日利亚下呼吸道感染人类免疫缺陷病毒患者的细菌感染和抗生素耐药性

下呼吸道感染 (LRTI) 与 HIV/AIDS 患者的死亡率和长期使用抗生素有关。从访问尼日利亚阿布贾大学教学医院的 134 名患有 LRTI 和咳痰的 HIV/AIDS 患者收集痰液样本，以确定细菌病因和抗生素耐药性。仅在 119 名受试者（75 名女性和 44 名男性）中观察到足够的培养痰样本，并使用标准程序进行培养。分离物通过生化方法和16SrRNA基因扩增、纯化、测序和数据库核苷酸爆炸进行鉴定。根据临床和实验室标准研究所 (CLSI) 程序进行和解释抗生素敏感性测试。在 20.2% 的患者和克雷伯氏菌中发现了与 LRTI 相关的细菌肺炎（29.7%）；阴沟肠杆菌(16.7%); 霍马氏肠杆菌亚种。香坊(12.5%); 假单胞菌；铜绿假单胞菌；嗜碱假单胞菌；产气克雷伯菌(8.3%); 睾丸毛单胞菌; 大肠杆菌；朱尼不动杆菌；不动杆菌和鲍曼不动杆菌被牵连。分离株对阿莫西林-克拉维酸（94.1%）、甲氧苄啶-磺胺甲恶唑（75.0%）和头孢噻肟（70.0%）显示出高抗性。大多数分离株 (62.5%) 的多重抗生素耐药性 (MAR) 指数在 0.3-0.8 范围内，范围为 0.0 至 0.8。发现同一物种的分离株在不同患者中具有不同的 MAR 指数。然而，E. cloacae、E. hormaechei subsp。香坊菌、鲍曼不动杆菌和 71.4% 的肺炎克雷伯菌是多药耐药（MDR）。有趣的是，庆大霉素、环丙沙星和亚胺培南对 MDR 分离株有效，并且与 MAR 指数呈显着负相关。我们建议对 MDR 分离株有效的抗生素可用于下调其他抗生素的选择压力，这些 MDR 病原体，包括那些很少与人类感染相关的病原体，构成潜在威胁，类似于耐甲氧西林金黄色葡萄球菌(MRSA)。特别是在免疫功能低下的人群中。此外，艾滋病毒/艾滋病患者提供了很好的指标来分析贫穷国家抗生素耐药细菌的负担和传播情况。