Antimicrobial Sensitivity in Enterobacteria from AIDS Patients, Zambia

James Mwansa, Kabanga Mutela, University of Zambia School of Medicine, University Teaching Hospital, Lusaka, Zambia; Isaac Zulu, University of Zambia School of Medicine, University Teaching Hospital, Lusaka, Zambia and St. Bartholomew's & Royal London School of Medicine, London, United Kingdom; Beatrice Amadi, University of Zambia School of Medicine, University Teaching Hospital, Lusaka, Zambia; Paul Kelly University of Zambia School of Medicine, University Teaching Hospital, Lusaka, Zambia and St. Bartholomew's & Royal London School of Medicine, London, United Kingdom

Disclosures

Emerging Infectious Diseases. 2002;8(1) 

In This Article

Abstract and Introduction

Enterobacteria contribute to two serious clinical syndromes seen in African AIDS patients: diarrhea and septicemia. In West Africa, prophylaxis with sulfamethoxazole-trimethoprim (SXT) reduced illnesses. We report reduced sensitivity of enterobacteria to available antimicrobial agents in Zambia, with only 22% of nontyphoidal salmonellae and 6% of shigellae sensitive to SXT.

Diarrhea and septicemia, two of the most important clinical problems of African AIDS patients, are both associated with high rates of illness and death. Treatment with antimicrobial agents may play an important role in reducing illness and possibly death. Chemoprophylaxis (for example, with cotrimoxazole or sulfamethoxazole-trimethoprim [SXT]) has been shown to be effective in reducing illness and death[1,2]. The evidence base relating to patterns of antimicrobial resistance in Africa is small, and antimicrobial agents are often chosen on the basis of availability and expense. Some evidence indicates that resistance patterns vary across Africa, with resistance to SXT in nontyphoidal salmonellae of 14% in Abidjan and 83% in Malawi[3]. We report the prevalence of infection with three major enterobacteria in Zambian adults and children with AIDS, followed by an analysis of antimicrobial sensitivity patterns.

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