Magnitude, Associated Factors and Antimicrobial Susceptibility Patterns of Salmonella and Shigella Species among Human Immunodeficiency VirusInfected Patients Attending Treatment at Hiwot Fana Comprehensive Specialized University Hospital, Harar, Eastern Ethiopia

Abstract

Salmonella and Shigella species are the main causative agents of diarrhea in people living with Human Immunodeficiency Virus. The magnitude, associated factors, and antibiotic sensitivity tests of Salmonella and Shigella species were not studied on Human Immunodeficiency Virus infected patients in the study area. Objective: To determine the magnitude, associated factors, and antimicrobial susceptibility patterns of Salmonella and Shigella species among Human Immunodeficiency Virus-infected patients attending treatment at Hiwot Fana Comprehensive Specialized University Hospital, Harar, Ethiopia from February 01 to April 30, 2024. Methods: An institutional-based cross-sectional study was conducted on 235 Human Immunodeficiency Virus-infected Patients with complaints of diarrhea. Data were collected through a face-to-face interview using a structured questionnaire. Stool samples were collected, inoculated to selenite F broth, and subcultured to MacConkey and Xylose Lysine Deoxycholate agar, and identified using biochemical tests. The modified Kirby-Bauer disk diffusion techniques were used to determine drug susceptibility patterns. Data were entered into Epi data version 3.1, and analyzed using Statistical Package for Social Sciences version 26. Logistic regression was performed to check an association between variables. A P-value < 0.05 was considered statistically significant The overall prevalence of Salmonella and Shigella species was 7.7 %( 95%CI 4.0-11.0). Salmonella species 4.7 %( 95% CI: 2.0-7.0) and Shigella species 3 %( 95% CI: 1.0-5.0). The highest resistance was seen for Salmonella species against Ampicillin (100%), Nalidixic acid (54.5%), Cotrimoxazole (45.5%) and Chloramphenicol (45.5%), for Shigella species against Ampicillin (100%), Tetracycline(85.7%), and Nalidixic acid (71.4%). and Co-trimoxazole (57.1%). unprotected source of water (AOR = 8.10, 95% CI: 1.54-42.61, p = 0.013), and clinical stage3 and4 (AOR = 27.27, 95% CI: 27.27(14.13-40.41), p = 0.001) were factors associated with Salmonella and Shigella infection . Conclusion: High prevalence of Salmonella and Shigella species were found. There were higher drug resistance and multidrug-resistant patterns. Providing safe potable water and improving clinical status are recommended