BACTERIAL PATTERNS OF RHINOSINUSITIS AMONG ADULT HIV PATIENTS WITH A CD4 COUNT ABOVE OR BELOW 200/μL ATTENDING THE AIDS SUPPORT ORGANISATION (TASO) MULAGO CLINIC

Abstract

Introduction: The HIV-associated Rhinosinusitis (RS) is reported with a prevalence of 11 to 70%. When the CD4 count is below 200/μL, RS becomes recurrent, severe and difficult to treat due to atypical bacterial aetiological agents.

Objective: This study aimed at determining the bacterial agents that caused rhinosinusitis among adult HIV patients with CD4 count above or below 200/µL at The Aids Support Organization (TASO) Mulago clinic and their antimicrobial sensitivity profiles. Methodology: It was a descriptive cross-sectional study, based at TASO Mulago, from February to April 2019. Adult HIV-positive antiretroviral therapy (ART) naïve - patients and those on ART for less than 3 months were screened for rhinosinusitis. Middle meatus swabs were collected for aerobic bacterial culture and antimicrobial sensitivity testing. Results: Coagulase-negative staphylococci (CoNS) (42.1%) and E. coli (15.7%) were the commonest bacteria among respondents with a CD4 count of 200/μL. CoNS (66%), S. aureus (23.4%) and K. pneumoniae (4.3%) were the commonest among respondents with a CD4 of 200/μL or above. CoNS showed less resistance to Tetracycline (25%) and E. coli showed no resistance to third generation cephalosporins among respondents with CD4 count below 200/μL. Among respondents with a CD4 of 200/μL or above, Staphylococci were less resistant to Gentamicin (22.5% and 0%) and Clindamycin (22.5% and 27.2%) and Tetracycline (29% and 27.2%). CoNS, S. aureus, and K. pneumoniae showed high resistance to Cotrimoxazole. Conclusion: CoNS and E. coli were the commonest bacterial agents in HIV-associated RS among patients with a CD4 count below 200/μL. CoNS, S. aureus, and K. pneumonia were the commonest bacterial agents among patients with a CD4 count of 200/μL or above. Staphylococci showed susceptibility to Tetracycline and the Enterobacteriaceae showed susceptibility to third-generation Cephalosporins in any CD4 count groups