Respiratory tract infections with more than one organisms are common in immunosuppressed patients, especially those who are Human immunodeficiency virus (HIV) positive. Mycobacterium tuberculosis and Streptococcus pneumoniae are the most important and dangerous pulmonary bacterial pathogens with global impact. This present study assessed the prevalence of Streptococcus pneumoniae and Mycobacterium tuberculosis co-infection and associated risk factors among HIV infected Adult Patients on Highly Active Antiretroviral Therapy (HAART) attending the HIV Clinic, Babcock University Teaching Hospital (BUTH), Ilishan-Remo, Ogun State, Nigeria.
Consenting 260 Participants (88 males and 172 females) with HIV positive status confirmed using, Determine HIV-1/2, Statpak HIV-1/2, and UniGold HIV-1/2 kits were randomly recruited for the study. Three consecutive early morning sputum specimens were requested from each participant in a disposable wide-mouthed, screw-cap, leak-proof sputum container examined both macroscopically and microscopically without delay using standard microbiological methods. Streptococcus pneumoniae was detected using Culture, Gram staining technique, bile solubility test and Optochin sensitivity test, while Mycobacterium tuberculosis was detected using the Ziehl-Neelsen staining technique. Prior to the specimen collection, demographic and clinical information of the subjects were obtained using prepared questionnaires which were administered to the participants and handled with utmost confidentiality.
Out of 260 participants examined, 23 (8.8%) were positive for Streptococcus pneumonia infection. The recovered S. pneumoniae isolates were sensitive to Septrin (78.3%), Gentamycin (73.9%), Ciprofloxacin (69.5%), Erythromycin (69.5%), Ampiclox (65.2%) and Amoxycillin (56.5%). Also, 56 (21.5%) of the 260 participants were positive for Mycobacterium tuberculosis infection; while 7 (2.7%) were positive for Streptococcus pneumoniae and Mycobacterium tuberculosis co-infection. Gender, marital status, religion, educational level and occupation were significantly (P < 0.05) associated with the prevalence of Streptococcus pneumoniae and Mycobacterium tuberculosis co-infection among the study participants. Identified risk factors include poor knowledge/awareness, history of pneumonia and tuberculosis, history of respiratory pathology and thoracic surgery, lack of vaccination with BCG and pneumococcal vaccine and less medical check-up.
This study confirms that co-pulmonary infection caused by S. pneumoniae and M. tuberculosis exist among HIV Patients on HAART in Ogun State, hence the need for greater public awareness, avoidance of implicated risk factors, regular medical check-up and immediate medical attention as the case may be, to avoid potential future complications associated with Streptococcus pneumoniae and Mycobacterium tuberculosis co-infectivity among HIV positive populace.