Mortality Results Based on Antimicrobial Resistance and HIV Status in a Low-Income Developing Country. A Monocentric Ambispective Study

Abstract

Kick Kayembe Kakese*, Daye Ka, Marie-Viviane Cisse, Bruce Wembulua and Franck Botalema

Multi-resistant bacteria represent a major public health problem throughout the world in general, and in sub-Saharan Africa in particular (1). Many patients admitted with infectious diseases are carriers of bacteria, some of which are multi- drug resistant, but only a few studies have been carried out to determine the factors that could influence the outcome of patients in hospital (2).

Besides, Previous studies have estimated the number of deaths associated with drug- resistant infections and sepsis and found that infections remain a leading cause of death globally (3).

The study assesses the impact of immune status on mortality associated with multi- drug resistant bacterial infections. This ambispective observational study was conducted from the 1st of January 2021 to the 31st of December 2022. The patients included during this period were adults admitted to hospital regardless of their HIV status, with a multi-drug resistant bacterial infection confirmed after culture and antibiotic susceptibility testing. The criteria for assessment were the occurrence of death and, consequently, the identification of factors associated with this mortality.

During the study period, 200 patients were included: 81 with positive HIV serology and 119 with negative serology. Considering the 2 groups according to their serological status, overall mortality was 20.17% in the HIV-negative group and 23.46% in the HIV-positive group, with no significant difference between the 2 groups (p-value: 0.6). On the other hand, co- infections and/or opportunistic infections accounted for a 2.82-fold increase in the risk of death in the HIV-positive group compared with the reference group (OR=2.82 [1.14-7.52] and p-value: 0.029).

HIV infection itself does not appear to have a direct impact on mortality associated with resistant bacterial infections, but factors associated with infection may contribute to an increased risk of mortality.

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