{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:30:11Z","timestamp":1789727411064,"version":"4.0.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Bacterial opportunistic infections are common in people living with HIV\/AIDS (PLHA). Besides HIV-TB co-infection, lower respiratory tract infections (LRTIs) due to multidrug-resistant (MDR) bacteria cause significant morbidity and mortality among PLHA. This study identified bacterial co-infection of the lower respiratory tract and detected plasmid-mediated <jats:italic>bla<\/jats:italic><jats:sub>TEM<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>CTX-M<\/jats:sub> genes among Extended-Spectrum \u03b2-Lactamase (ESBL) producing isolates from sputum samples in PLHA.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A total of 263 PLHA with LRTIs were enrolled in this study, out of which, 50 were smokers, 70 had previous pulmonary tuberculosis, and 21 had CD4 count\u2009&lt;\u2009200 cells\/\u00b5l. Sputum samples collected from PLHA were processed with standard microbiological methods to identify the possible bacterial pathogens. The identified bacterial isolates were assessed for antibiotic susceptibility pattern using modified Kirby Bauer disk diffusion method following Clinical Laboratory Standard Institute (CLSI) guidelines. In addition, plasmid DNA was extracted from MDR and ESBL producers for screening of ESBL genes; <jats:italic>bla<\/jats:italic><jats:sub>CTX-M<\/jats:sub> and <jats:italic>bla<\/jats:italic><jats:sub>TEM<\/jats:sub> by conventional PCR method using specific primers.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 263 sputum samples, 67 (25.48%) showed bacterial growth. Among different bacterial pathogens, <jats:italic>Klebsiella pneumoniae,<\/jats:italic> (17; 25.37%) was the most predominant, followed by <jats:italic>Haemophillus influenzae,<\/jats:italic> (14; 20.90%) and <jats:italic>Escherichia coli<\/jats:italic>, (12; 17.91%). A higher infection rate (4\/8; 50%) was observed among people aged 61\u201370\u00a0years, whereas no infection was observed below 20\u00a0years. About 30.0% (15\/50) of smokers, 32.86% (23\/70) cases with previous pulmonary tuberculosis, and 52.38% (11\/21) with CD4 count\u2009&lt;\u2009200 cells\/\u00b5l had bacterial LRTIs. Among 53 bacterial isolates excluding <jats:italic>H. influenzae<\/jats:italic>, 28 isolates were MDR and 23 were ESBL producers. All ESBL producers were sensitive to colistin and polymyxin B. Among ESBL producers, 47.83% (11\/23) possessed <jats:italic>bla<\/jats:italic><jats:sub>CTX-M<\/jats:sub>, 8.6% (2\/23) were positive for <jats:italic>bla<\/jats:italic><jats:sub>TEM<\/jats:sub> gene, and 43.48% (10\/23) possessed both ESBL genes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The increasing rate of MDR bacterial infections, mainly ESBL producers of LRTIs causes difficulty in disease management, leading to high morbidity and mortality of PLHA. Hence, it is crucial to know the antibiogram pattern of the isolates to recommend effective antimicrobial therapy to treat LRTIs in PLHA.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-022-07503-2","type":"journal-article","created":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T09:02:41Z","timestamp":1654592561000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Multidrug-resistant bacteria with ESBL genes: a growing threat among people living with HIV\/AIDS in Nepal"],"prefix":"10.1186","volume":"22","author":[{"given":"Riju","family":"Maharjan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anup","family":"Bastola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabaraj","family":"Adhikari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Komal Raj","family":"Rijal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megha Raj","family":"Banjara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash","family":"Ghimire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upendra Thapa","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,6,7]]},"reference":[{"key":"7503_CR1","unstructured":"WHO. 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A copy of the information sheet and a consent form was given to the participants to obtain written consent before enrollment in the research and collecting samples. In addition, a local language-translated information sheet was read for illiterate participants. Informed consent was obtained from all the participants. In the case of children under 16\u00a0years, both written informed consent with assent was obtained from a parent or a local guardian attending the hospital along with the participant. All the methods were carried out in accordance with the principles stated in the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"We declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"526"}}