Sonal Gupta¹*, Aruna Solanki²and P K Khatri³

¹MBBS, MD Microbiology, Ex-Resident, Dr S N Medical College, Jodhpur, India
²Ex-Professor and HOD, Department of Microbiology, Dr S N Medical College, Jodhpur, India
³Professor and HOD, Department of Microbiology, Dr S N Medical College, Jodhpur, India

*Corresponding Author: Sonal Gupta, MBBS, MD Microbiology, Ex-Resident, Dr S N Medical College, Jodhpur, India.

Received: February 03, 2025; Published: March 05, 2024

Abstract

Introduction:Bacterial pneumonia is reported to be more frequent in HIV positive patients as compared to seronegative and the rate of bacterial pneumonia increased with decreasing CD4 lymphocyte counts. The aim of the present study is to ascertain the spectrum of bacterial pathogens causing lower respiratory tract infections in HIV positives in western Rajasthan, microbiological and radiological correlation and to find out variation in CD4+T Lymphocytes, CD8 +T Lymphocytes and CD4/CD8 ratio in HIV positive and HIV negative patients having LRTI.

Material and Methods: A case control prospective study conducted. With a preset protocol a history of clinical signs, and symptoms, radiological findings, routine lab. Investigations was collected. CD4+ T and CD8 + T Lymphocyte counts of the samples under study was estimated by Flow Cytometry using BD FACS Calibur.

Results: Polymicrobial isolation was found to be more in study group. Among the bacterial isolates in the study group, S aureus was isolated in 42.8%, K. Pneumoniae 11.9%, E. coli 4.7% and P. aeruginosa in 9.52%. M tuberculosis was isolated in 8% in the study group. Radiological findings like focal consolidation and military pattern was observed in the study group with M. Tuberculosis isolation. In the study group, mean CD4 counts 214 ± 120 cells/ul, mean CD8 counts 940 ± 168 cells/ul and CD4/CD8 ratio: 0.23 ± 0.11, was found.

Conclusion: HIV positive Patients with LRTI should undergo diagnostic evaluation for specific pathogens that would alter the standard treatment. Also, low CD4 counts predisposes the HIV positive patients to bacterial LRTIs.

Keywords: LRTI; HIV; Polymicrobial

References

1. National AIDS Control organisation (NACO). India HIV estimations, Technical report, (2015).
2. Huang L and Crothers KA. “HIV-associated Opportunistic Pneumonias”. Respirology (Carlton, Vic)4 (2009): 474-485.
3. Fuselier PA., et al. “Infections of lower respiratory tract, chapter 56”. In; Bailey and Scott’s diagnostic Microbiology 11th edition, Forbes BA Salim DF, Weissfeld AS (Eds) Mosby (2002): 889.
4. Giri PA., et al. “Prevalence of Pulmonary Tuberculosis Among HIV Positive Patients Attending Antiretroviral Therapy Clinic”. North American Journal of Medical Sciences6 (2013): 367-370.
5. Mohanty KC., et al. “HIV Infection in patients with respiratory Disease”. Indian Journal of Tuberculosis 40 (1993): 5-12.
6. Escott S., et al. “Management of TB in countries with high HIV prevalence”. African Health 23 (2001): 12-15.
7. Kohli R., et al. “Bacterial pneumonia, HIV therapy and disease progression among HIV infected women in the HIV epidemiologic research (HER) study”. Clinical Infectious Disease 43 (2006): 90.
8. Chieu Liu and Dasaraju PV. “Infection of the respiratory system in Medical Microbiology”. 4rth Edition. Baron Samual, Human M, James DA et al (Eds) (1996).
9. Cadranel J., et al. “Pyogenic bacterial Lower Respiratory Tract Infection in Human Immunodeficiency Virus infected patients”. European Respiratory Journal (2002): 28-31.
10. Manual of Quality Standards for HIV Testing Laboratories. National AIDS Control Organisation, India, 2007 Chapter 2.
11. Oberoi A and Kaur H. “Comparison of Rapid Colorimetric method in the isolation of Mycobacterium tuberculosis”. IJMM1 (2004): 44-46.
12. Winn Washington C., et al. “Koneman's color atlas and textbook of diagnostic microbiology”. Philadelphia : Lippincott Williams and Wilkins (2006).
13. FACS Calibur™ System User’s Guide.
14. Kothari K and Goyal S. “Clinical profile of AIDS”. JAPI 49 (2002): 435-438.
15. Kamat HA., et al. “Increasing prevalence of HIV-2 and dual infection among high risk group hospital admitted patients in Mumbai”. Indian Journal of Medical Science11 (1998): 479-484.
16. Xavier TF., et al. “Isolation and characterization of opportunistic bacterial and fungal pathogens from hospitalized HIV/AIDS patients of Namakkal District in Tamil Nadu”. World Journal of Pharmacy and Pharmaceutical Sciences7 (2017): 742-750.
17. Bollinger RC., et al. “Risk factors and clinical presentation of acute primary HIV infection in India”. JAMA33 (1997): 2085-2089.
18. Hirschtick RE., et al. “Bacterial pneumonia in persons infected with the human immunodeficiency virus. Pulmonary Complications of HIV Infection Study Group”. The New England Journal of Medicine 13 (1995): 845-851.
19. Zar HJ. “Pneumonia in HIV infected and HIV uninfected children in developing countries :epidemiology, clinical features and management”. Current Opinion in Pulmonary Medicine3 (2004): 176-182.
20. Shreevidya K and Dias M. “Pulmonary bacterial and fungal infections in human immunodeficiency virus patients: A study from India”. Annuals of Topical Medicine and Public Health Year2 (2012): 80-84.
21. Shailaja VV., et al. “Prevalence of Bacterial and fungal agents causing Lower Respiratory Tract Infections in patients with HIV infection”. IJMM1 (2004): 28-33.
22. Schneider RF. “Bacterial pneumonia”. Seminars in Respiratory Infections4 (1999): 327-32.
23. Yarlagadda P. “Etiology of opportunistic respiratory tract infections in patients suffering with HIV/AIDS from a tertiary care hospital, Chinakakani, Andhra Pradesh”. International Journal of Research in Medical Sciences 8 (2015): 1974-1978.
24. Enarson DA., et al. “Management of tuberculosis, a guide for low income Countries”. 5th ed. Paris: 2000. International union against tuberculosis and lung disease (IUATLD) Tuberculosis and HIV (2000): 10-53.
25. Badie BM., et al. “Comparing Radiological Features of Pulmonary Tuberculosis with and without HIV Infection”. Journal of AIDS Clinical Research 3 (2012): 188.
26. Bakari M., et al. “Basis for treatment of tuberculosis among HIV-infected patients in Tanzania: the role of chest x-ray and sputum culture”. BMC Infectious Disease 8 (2008): 32.
27. M Bharathi and A Usha Rani. “Pathogenic fungal isolates in sputum of HIV positive patients”. Journal of AIDS and HIV Research6 (2011): 107-113.
28. Ojha CR., et al. “Lower respiratory tract infections among HIV positive and control group in Nepal”. Virus Disease 1-2 (2015): 77-81.
29. Lubega G., et al. “The bacterial profile and antibiotic susceptibility pattern in respiratory tract samples from art-experienced HIV-positive adults in Uganda”. PLoS One 8 (2023): e0282936.
30. Brecher CW., et al. “CT and radiography of bacterial respiratory infections in AIDS patients”. AJR American Journal of Roentgenology5 (2003): 1203-1209.

Citation

Citation: Sonal Gupta., et al. “Isolation of Bacterial Agents Causing LRTI in HIV Positive Patients; Radiological Corelation and CD4 Status from a Tertiary Care Centre".Acta Scientific Microbiology 8.4 (2025): 58-62.

Copyright

Copyright: © 2025 Sonal Gupta., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.