Title: STUDY OF OPPORTUNISTIC PATHOGENS IN LOWER RESPIRATORY TRACT INFECTIONS AMONG SUBJECTS WITH ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) IN A TERTIARY CARE CENTRE OF TRIPURA
Abstract: BACKGROUNDOrganisms responsible for opportunistic infections (OIs) differ in characteristics from that of conventional communicable disease causing agents and are mainly of low virulence, or are non-virulent.OI usually sets in when there is a gradual decline of CD4 count from 500/mm 3 and life threatening OIs occur in CD4 count below 200/mm 3 .Aim and Objective-To study the opportunistic pathogens in Lower Respiratory Tract Infections (LRTIs) among subjects with Acquired Immune Deficiency Syndrome (AIDS) with objectives of isolation and identification of the bacterial and mycotic agents responsible for this condition, and establishing a correlation between the spectrum of opportunistic infections with CD4 count. MATERIALS AND METHODSStudy period was from January 2014 to December 2015, two consecutive sputum samples were collected and inoculated for bacterial and fungal culture following Gram stain and KOH wet mount.Isolated colonies were identified by standard biochemical test.CD4 estimation was done by using BD FACS machine as per the manufacturer's protocol. RESULTSOut of the 151 cases, 70.19% (106/151) were culture positive.Among the culture positive cases, bacterial isolates were seen in 78.31% (83/106), while fungi were seen in 21.69% (23/106).The most prevalent bacterial pathogen was Mycobacterium tuberculosis (MTB) 51.88% (55/106), Staphylococcus aureus 19.81% (21/106), Pseudomonas aeruginosa 16.98% (18/106), Klebsiella pneumoniae 10.37% (11/106), Citrobacter koseri 7.54% (8/106) and Citrobacter freundii 2.83% (3/106) and in fungal pathogens the most prevalent is Candida albicans 11.32% (12/106) and Candida guilliermondii 10.37% (11/106).CD4 count was found to be below 500/μL among the culture positive study subjects. CONCLUSIONRespiratory pathogens were found to be important opportunistic agents among HIV/AIDS positive patients.This study shows that MTB infection and Candidal infection are commonest among bacterial and fungal agents.CD4 estimation helps in early diagnosis and management of suspected LRTI patients with HIV.