Molecular characterization and antibiotic sensitivity testing of bacteria in blood cultures of Hepatitis B virus infected subjects

Introduction: Hepatitis B virus is one of the most common infections worldwide. Many infected people are at risk of developing liver complications. Screening for common pathogenic bacterial infections that could contribute to complications is important for early diagnosis and appropriate management.Methods: A cross sectional study was carried out on subjects aged 20-75 years for a period of 6 months (November 2016 to April 2017). Blood cultures and HBsAg rapid tests were performed on all 122 blood samples collected in Ilorin Metropolis. The screening was carried out on 92 HbsAg positive patients who presented with fever, and 30 apparently healthy HbsAg positive donors from the blood bank.Results: Of 92 symptomatic patients, 44 (47.8%) had postive blood cultures and of the 30 HBV positive blood donors, 9 (30%) had positive blood cultures.The prevalence of Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae in Hepatitis B positive subjects was 5.7% (n=7), 5.7% (n=7), 23.8% (n=29) and 9.8% (n=12) respectively. In the apparently healthy HbsAg positive blood donor group, only 9 samples showed positive bacterial growth of P. aeruginosa.All the bacterial isolates were resistant to amoxycillin-clavulanic acid, erythromycin, ceftriaxone, ceftazidime, cefuroxime, and ciprofloxacin. On PCR, Nuc, Stx2, Pf and PSUE genes were demostrated in E. coli, S. aureus, P. aeruginosa and K. pneumoniae respectively.Conclusion: This study showed a high percentage (45.1%) of bacteraemia in HBV infection. Early screening and treatment of HBV infection and concomitant bacterial infection is recommended to prevent complications.