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Bacterial Colonization of the Vagina, Oropharynx, Breast Milk And Journal of Microbiology & Experimentation Research Article Open Access Bacterial colonization of the vagina, oropharynx, breast milk and anterior nares of neonates among HIV seropositive pregnant women and seronegative pregnant counterparts Abstract Volume 7 Issue 2 - 2019 Introduction: The human Immunodefiency virus/acquired immune deficiency Kwashie Ajibade Ako-Nai, Blessing Omo- syndrome (HIV/AIDS) is a scourge to mankind because the disease has devastated and decimated communities worldwide in the last two or more decades, yet there is no Omorodion Department of Microbiology, Obafemi Awolowo University, cure. Incidence of HIV/AIDS in Nigeria is high, where 10% of the global incidence Nigeria occurs. The study determined the colonization of the vagina, oropharynx, breast milk and nares of neonates in clinics at Akure South and Ifedore Local Government Area Correspondence: Kwashie Ajibade Ako-Nai, Department of (LGA) in Ondo State, Nigeria from November 2015 to December 2016. Microbiology, Obafemi Awolowo University, Ile-Ife, Nigeria, Tel +2348034026689, Email Methodology: Two hundred and forty pregnant women aged 19-43 years were involved in the study. 114 HIV seropositive subjects mean age 31.81 years and 126 Received: March 20, 2019 | Published: April 11, 2019 HIV seronegative subjects mean age 29.05 years as controls. HIV serostatus of each participant was determined by HIV-1/2 strip and confirmed by the Abbott enzyme- linked immunosorbent assay procedure. High vaginal sawbs, breast milk samples, oropharynx swabs and nares of each neonate were collected using sterile cotton-tipped applicator and introducing each into freshly prepared thioglycollate fluid medium for growth. Bacterial isolates were charcterised by standard microbiological methods and API kits. Results: 2,148 bacterial isolates were recovered from the four study sites, HVS 1,156(53.8%), oropharynx 466(21.7%), breast milk samples 153(7.1%) and anterior nares of neonates 373(17.4%). Our study showed 60.5% against 39.5%, 68.2% compared to 31.8% and 73.8% against 26.2% of the predominant pathogens encountered among HIV seropositive and seroneagtive subjects respectively. Conclusion: HVS constituted the major isolates (53.8%), oropharynx (21.7%), breast milk (7.1%) and nares of neonates (17.4%). Keywords: HIV, bacterial colonization, HVS, oropharynx, breast milk, anterior nares of neonates Introduction 2012.4 Nigeria accounts for 10% of global HIV/AIDS,5,6 of which 1.72 millions are women within the ages of 35-49 years mostly in their The human Immunodefiency virus/acquired immune deficiency reproductive years. syndrome (HIV/AIDS) is a scourge to mankind because the disease has devastated and decimated communities worldwide in the last two Therefore, Mother-To-Child-Transmission (MTCT) is a major or more decades.1,2 The etiological agent was identified separately concern in Nigeria which ranks highest in children acquiring by Luc Montanier (Pasteur Institute, Paris), who shared the Nobel HIV in the world.7 HIV/AIDS is becoming a disease of poverty in Prize for his discovery in 2008, and Robert Gallo National Institutes developing countries especially in sub- Saharan Africa which bears of health (NIH). Bethesda Maryland, USA.3 Recent advancements a disproportionate number of the population.5–-7 The illicit sex trade in molecular biology and gene technology have contributed to the practices particularly among young girls and women have made understanding of enormous complexity of HIV genome which has women and young girls vulnerable.7 Worldwide, Nigeria has the invariably led to the rapid development of tools and strategies to second highest rates of new infections reported each year with an reduce HIV transmission, high rates of mortality and increase in life estimated 3.7% of the population living with HIV.6 In sub -Saharan expectancy among sufferers.2 In the last ten years, great advancements Africa about 60% of people living with HIV/AIDS are females and have been made in understanding the genomic structure of the virus 50% of the global population living with HIV/AIDS are females.4 and related subtypes like the simian immunodeficiency virus (SIV)2,4 Each year 55% of AIDS deaths occur among women and girls. There and understanding of the genome2 of the HIV and associate subtypes are many risk factors that contribute to the spread of HIV including which have given scientist insights to the organization of the virus and prostitution, high risk practices among itinerant sex workers, high has led to the formulation of ARV drugs which reduced the burden prevalence of sexually transmitted diseases, high risk heterosexual of infection in patients. Globally approximately 35.3 million people and homosexual practices in Nigeria.4,6 The microbiota of the woman suffers from HIV/AIDS in addition, 2 million new cases occurred in vagina is complex consisting of microbial communities that are Submit Manuscript | http://medcraveonline.com J Microbiol Exp. 2019;7(2):116‒126. 116 © 2019 Ako-Nai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially. Copyright: Bacterial colonization of the vagina, oropharynx, breast milk and anterior nares of neonates among HIV 117 seropositive pregnant women and seronegative pregnant counterparts ©2019 Ako-Nai et al. useful to her health, some are indigenous/normal micro flora that done at the onset of the study during which subjects were at their third can become opportunists.8 HIV/SIV infection has been shown to be trimester of pregnancy. Participants were also encouraged to keep all associated with microbiome shift and immune activation that may physician appointments throughout the study after consenting and affect the outcome of the disease progression.8 Similarly, it has been fully registered. reported that altered microbiome and inflammation are associated with increased risk of HIV acquisition suggesting the role of microbiome Exclusion criteria 8 in HIV transmission and MTCT. Those subjects who did not fall into the above categories, i.e Brenchley et al.,9 and Hunt10 have shown that persistent activation subjects (whose HIV status was known) that did not comply with was a key factor of HIV and markers of inflammation which predict revisit and those who declined involvement in the study were not clinical outcome than viral load. Brenchley et al.,11 have reported included. activation and inflammatory markers declined with antiretroviral Collection of High Vaginal Swab therapy (ART) but remained high compared to healthy individuals. An HIV-infected individual suffers from significant gastrointestinal Isolation and identification of bacterial isolates pathology than HIV-uninfected individuals.12 The gut -associated A sample of high vaginal swab was collected from the posterior lymphoid tissue (GALT) is a unique site for early HIV replication and fornix from each pregnant women by the attending physician using severe CD4 cell depletion. Studies have revealed that the breakdown sterile bivalve speculum (Changzhou Huankang Medical Devices of the mucosal surface can lead to microbial translocation, a major Co. Ltd, Changzhou City 213116, Jiangsu Province, China) and factor that complicates HIV/AIDS progression.13 Therefore, persistent sterile cotton-tipped applicator (Evepon, Industrial Limited, Onitsha, viral replication in the GALT has been shown to be responsible for Anambra State, Nigeria) into freshly prepared sterile thioglycollate replenishment and maintenance of the viral reservoirs seen in an medium and incubated at 37oC for 24 h for growth. After growth was HIV/AIDS patient. MTCT is increased in neonates because of the observed, a loopful of the sample was streaked initially with the aid of permeability of HIV across the thin gastrointestinal epithelium in heat- flamed standard aluminium wire loop (delivering 0.001 ml on to neonates.14 Therefore, knowledge of the bacterial agent(s) colonizing freshly prepared agar plates - Blood agar, Proteose peptone agar and the vagina, oropharynx and breast milk, among HIV seropositive Mannitol salt agar). Thereafter, the plates were incubated aerobically women compared to HIV seronegative participants that severed as at 37oC for 24 h and anaerobically in AnaeroPack jar 2.5 Litre, Order controls at healthcare clinics in Akure south and Ifedore LGA in Ondo No. 50-25, product of Mitsubishi Gas Chemical Company Co., Inc. State is desirable, hence our study that isolated, identified, compared Japan (all samples were analysed within 24 hours of collection) for communities involved. We are not aware of similar studies done in growth. Only plates on which colonies appeared were examined. this environment. We believe our findings will assist clinicians and Each distinct colony appearing on agar plates was picked and researchers to understand the changing microbial communities in further studied. Each colony was classified based on cultural and these sites, their role in pathogenesis and treatment in event of an morphological characteristics such as size, elevation, opacity and epidemic among HIV seropositive and seronegative pregnant mothers. colour on media plates. Initial Gram’s stain was prepared for each We believe our findings will enable clinicians to better manage colony and further identification of each colony was based on their treatment and provide data base which hitherto does not exist in this reaction on conventional enriched, selective and
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