Title:Salmonella serovars associated with bacteraemia infection in persons infected with human immunodeficiency virus with low CD4 cell counts in Akwa Ibom State, Nigeria. 

Author:Dora I Udoh, Aniekan-Augusta O Eyo, Anne E Asuquo and Simon J Utsalo

Abstract:Background: Certain serovars of Salmonella show a much higher predilection for causing bacteraemia as opportunistic infections in human immunodeficiency virus (HIV) infected persons.
Objectives: The study was undertaken to characterize serovars of Salmonella isolated from bacteraemia infections in HIV/AIDS patients in Akwa Ibom State and to determine the relationship of the infection with the low CD4+ cell counts of the subjects.
Materials and Methods: A cross-sectional descriptive epidemiological study was conducted among 300 HIV/AIDS patients and 105 non-HIV subjects. Blood culture samples were collected and cultured on Salmonella-Shigella agar (SSA) and Deoxycholate citrate agar (DCA) for recovery of Salmonellae. Isolates were identified using conventional tests and MicrogenTM GN ID System (Microgen Bioproducts). Serotyping was done using Salmonella antisera (Statens Serum Institut, Denmark). Estimation of CD4+ cell counts was by Partec flow cytometry.
Results: Salmonella species and Salmonella enterica arizonae were identified. Seven serovars were obtained; S. typhi, S. paratyphi A, S. paratyphi B, S. paratyphi C, S. typhimurium, S. cholerasius and S. enteritidis. The prevalence of Salmonella associated bactereamia was significantly higher (p<0.05) in HIV persons with 13.7% in contrast to 3.8% non-HIV subjects. Regardless of the HIV/AIDS sero-status, subjects with CD4+ counts below 200μL had the highest rates of Salmonella associated bacteraemia.
Conclusion: Salmonella typhi, S. paratyphi A, S. paratyphi B, S. paratyphi C, S. typhimurium, S. cholerasius and S. enteritidis are identified as serovars of Salmonella which are endemic in the study area and associated with bacteraemia infection with significantly higher occurrence in subjects with low CD4+ counts compared to HIV seronegative subjects.
Keywords: Salmonella, Bacteraemia, HIV infection, CD4+ counts.
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