Description of invasive bacterial infections in patients with advanced HIV hospitalized in Kabinda hosptial, Kinshasa, DRC
Study design
Prospective descriptive study
Context
Patients with advanced HIV disease (AHD), defined as WHO clinical stage 3 or 4 and/or CD4 <200 have a high risk of death. One common cause of death is invasive bacterial infection (IBI, i.e., septicemia or meningitis). The global increase of antibiotic resistance threatens current treatments against bacterial infections. This study aims to describe the burden of IBI among patients with AHD to guide empirical treatment protocols
Purpose
Our study aimed to describe the prevalence and aetiology of IBIs and the antibiotic resistance of bacteria identified in patients with advanced HIV hospitalised at the Kabinda Hospital Centre (CHK) in Kinshasa, DRC.
Our role
Coordination
Partners
- Ministry of health, DRC
- Hôpital général de Kabinda, Kinshasa
Methods
This is a prospective, descriptive study implemented at Kabinda General Hospital in Kinshasa, Democratic Republic of Congo (DRC). All patients with AHD and a blood or cerebrospinal fluid (CSF) culture collected because of: 1) fever/hypothermia and/or signs of shock, on admission or during hospitalization, and/or 2) previous exposure to care (48 hours after hospitalization.
Results
From August 2021 to July 2022, we included 997 patients, corresponding to 1198 hospitalizations with ≥1 blood and/or CSF culture. The proportions of communityacquired, healthcare-associated, and hospital-acquired IBI among hospitalizations were 5.9% (71/1198), 9.2% (110/1198), and 3.5% (42/1198), respectively. The main bacterial agents responsible for community-acquired and healthcare-associated IBI were non-Typhi Salmonella followed by Gram-positive Cocci, while K. pneumoniae was most common in hospital-acquired IBI. The levels of antibiotic susceptibility among Enterobacterales were similar between community-acquired and healthcare-associated IBI, with low susceptibility to ceftriaxone and ciprofloxacin, but high susceptibility to carbapenems and azithromycin.
Conclusion
We confirmed alarming levels of antibiotic resistance among patients with ADH in the DRC. Discussions are ongoing to translate results into practice, in particular to target broad spectrum empirical antibiotics.
