In-vitro susceptibility of gut pathobiont associated with microbial translocation to cotrimoxazole and antiretroviral

The human gut microbiota consortium consists of microorganisms that are sensitive to some antimicrobial agents. These gut microbiota are essential in upholding a healthy gut environment. A few of the gut microbiota has been described as pathobiont, which is involved in microbial translocation that drives systemic inflammation in immunocompromised individuals. Conjoin utilization of cotrimoxazole as prophylaxis and antiretroviral therapy (ART) has shown to reduce microbial translocation markers lipopolysaccharides binding proteins (LBP) and sCD14 in HIV-infected individuals, but the mechanisms underlying these clinical benefits have not been exploited. Our study was aimed at investigating the effect of HAART and cotrimoxazole on gut pathobiont that has been associated with microbial translocation among HIV-positive treatment-naive patients and HIV-negative individuals. A Cross-Sectional study design was used involving 62 participants; of which 31 were HIV-positive naïve patients (target group), while 31 others were HIV-negative individuals (control group). Stool specimens from all the participants were collected and processed aseptically using six culture medium and 14 culture conditions from August 2018 to January 2019. Results showed that pathobionts including E.coli, Klebsiella spp, Proteus spp, Salmonella spp, Enterobacter spp, Staphylococcus aureus, and Clostridium spp were sensitive to cotrimoxazole with74.5%, 100%, 66.7%, 100%, 100%, 100% and 100% respectively. Members belonging to the Enterobacteriaceae family were all sensitive to antiretroviral with zidovudine combinations. All Staphylococcus aureus 44 (100%) were sensitive to Efavirenz. The proportions of Susceptible and resistant cultured gut microbiota to cotrimoxazole and HAART between HIV-negative individuals and HIV-positive treatment naïve patients were not significantly different (p = 0.635). Cotrimoxazole and some antiretrovirals could reduce pathobiont burden in HIV immunocompromised patients. The synergy between cotrimoxazole and zidovudine based combinations may explain the clinical benefits of low microbial translocation among HIV-infected individuals on treatment from previous studies, thus providing further rationale for extending coverage.