Etiology and Antimicrobial Resistance Pattern of Sepsis and Urinary Tract Infections in HIV-Infected Patients from Southwestern Iran

Sepsis is a systemic inflammatory response syndrome triggered by an infectious agent and an important cause of admission to intensive care units (ICU), especially in immunodeficient patients. The aim of this study was to determine the spectrum of bacterial etiology and antibacterial susceptibility pattern of sepsis and urinary tract infections (UTIs) in Iranian HIV-infected patients.

This retrospective cross-sectional study was conducted on HIV/AIDS patients for a period of ten years from January 2005 to January 2015 at two major hospitals in southwestern Iran. Standard microbiological methods were used for the isolation and identification of bacteria from samples. Antimicrobial susceptibility tests were done using disk diffusion method.

Out of 228 samples collected, the frequency of culture-positive blood and urine samples was 23.2% (n = 53) and 9.6% (n=22), respectively. Among culture-positive blood samples, Staphylococcus aureus (N = 17, 32.1%) and Pseudomonas (N = 5, 9.4%) were the main etiologic agents. While among 22 culture-positive urine samples, the predominant bacteria were Enterococci (N = 7, 31.8%) and Escherichia coli (N = 5, 22.7%). Antibacterial susceptibility testing results showed that Gram-positive bacteria were mostly susceptible to vancomycin, rifampin, and co-trimoxazole; meanwhile, Gram-negative bacteria were mostly susceptible against tobramycin, amoxicillin/clavulanate, and aztreonam.

In summary, this study findings highlighted the emergence and spread of opportunistic infections and a high level of antibiotic resistance among HIV-infected patients; therefore, restricted infection control strategies must be pursued in these hospitals.