Comparing the Antibiotic Resistance Profiles of Klebsiella pneumoniae in HIV-positive and HIV-negative Individuals Attending the Bamenda Station Polyclinic, Bamenda, Cameroon

Abstract

The vulnerability of human immunodeficiency virus (HIV) patients to opportunistic pathogens requires measures in monitoring the spread of antibiotic resistance (ABR). ABR to Klebsiella pneumoniae is an urgent threat to human health. This study aimed to determine the prevalence and antimicrobial susceptibility patterns of K. pneumoniae in HIV positive and negative persons in Bamenda III. The study comprised of 333 participants (133 HIV positive and 200 HIV negative persons) recruited from January 2024 to June 2024. K. pneumoniae was isolated from urine samples by culture on selective media. Antibiotic susceptibility testing was done using the Kirby Bauer Disc diffusion method. The prevalence of K. pneumoniae was 23.4% (78/333) and was high 24.0% (48/333) in HIV positive participants though the difference was not significantly (p=0.761). Of the 78 isolates, 77(98.7%) showed resistance to at least one of the antibiotics used. Ampicillin recorded the highest level of resistance (61.05%, 48/77) while Nitrofurantoin was the most active drug 42.3% (28/78). Multidrug resistance (MDR) was reported in 47.4% (37/78) of the participants. Secondary level of education (AOR=6.75, p=0.040), monthly income of less than 50,000frs (AOR=5.53, p=0.025) and HIV positive status (AOR=0.30, p=0.039) were identified as risk factors of MDR. This study reported high prevalence of K. pneumoniae in the urine samples of both HIV positive and negative participants. These isolates demonstrated resistance to most antibiotics with a higher level of antibiotic resistance observed in isolates from HIV positive persons. We recommend the need for controlled administration of ampicillin and gentamycin while encouraging the use of nitrofurantoin and levofloxacin in the treatment of K. pneumoniae especially in HIV patients.