Immune Suppression and Antimicrobial Resistance in Hospitalised HIV Patients: Evidence from Free State and Northern Cape Hospitals.

Background: Globally, studies has shown that microorganism infections are responsible for high rate of morbidity and mortality among immune-compromised patients. Such an increase is being observed in Sub-Saharan countries, particularly in Intensive-Care Units. Such an increase is be attributed by different factors such as age, immune status, pre-existing disease and diagnostic or therapeutic interventions. The deadly twin diseases namely HIV and TB made chronic patients more prone and susceptible to other opportunistic microorganisms. Objectives: The study aimed to determine the prevalence microbial population in immunocompromised patients hospitalized in the different hospitals living with TB or/and HIV positive. Secondly to identify factors posing risks in the target study population, and to determine the antimicrobial prevalence rate in the different hospital wards. Methods: This was ethically approved a retrospective, cross-sectional study using data collected over a period of five years with inclusion criteria being that patient should have TB or / and HIV at the time of hospitalization Results: Forty-eight thousand five hundred ninety seven met the inclusion criteria in the study with majority from the Frances Baard District Municipality in Kimberley (NC) (58.4%), and Mangaung Metropolitan Municipality (FS) accounted for 37.9%. Most patients (58.4%) where treated at RM Sobukwe hospital, followed by 20.9% patients treated at the Universitas Academic hospital. The highest age (28-37) group accounted for 27.1%, and second most been 38-47 years at 26.4%, the least population (0.8%) aged (78-87) years. Fewer patients were admitted to hospitals age (58 years and above) and majority were female (49.9%) with 0.7% of the patients’ gender was unknown. Majority of patients (89.4%) tested negatively with 6.8% patients tested positively for TB across all six hospitals, while 1.6% and 1.8% patients’ TB results were unknown or not tested, respectively. The highest number of patients testing positive for TB was recorded at the National Hospital (9.7%), Bongani Hospital (8.3%). RM Sobukwe Provincial hospital reported n=2,226 (7.8%) TB-positive cases, Mofumahadi Manapo Mopeli hospital (7.1%) TB-positive cases, Pelonomi hospital (6.3%) positive cases, and Universitas Academic hospital h (3.6%) TB-positive cases. Majority patients’ group (70.9%) were not HIV-1/2 rapid screen tested, of those tested 1.2% were found to be HIV positive while 4.2% tested negative. The results showed that majority (70.9%) were not screened, while 4.3% were positive a significant 24.4% were negative. The results showed that only 0.6% of the patients encountered unclear HIV outcomes The data show that fewer (7.9%) patients test showed undetectable HIV (100,000 copies/mL. A significant 74.9% of patients were not tests HIV. The data showed that most patients (68.9%) had no CD4 ARV results, an indication of less monitored immune systems. Weak immune system (