Respiratory tract infection caused by bacteria (non-Mycobacterium) and their antibiogram in HIV-positive patients.

Abstract. This study was undertaken from 1995-2000 to investigate the cause of respiratory tract infection among 481 patients with human immunodeficiency virus (HIV) at Siriraj Hospital, Bangkok, Thailand. The positive rate of bacterial pathogens was 38.46%. Pseudomonas aeruginosa appeared to be the most common pathogen (32.97%), followed by Staphylococcus aureus (18.92%), Klebsiella pneumoniae (10.81 %), Haemophilus influenzae (7.57%), and Acinetobacter baumannii (5.95%). P. aeruginosa was sensitive to netilmycin, amikacin, imipenem, meropenem, cefoperazone/sulbactam, piperacillin/tazobactam, and gentamicin (67-84%). S. aureus was sensitive to vancomycin and teicoplanin (100%).

Bacterial study of autopsy specimens.

Autopsy reports were reviewed for the detection of infectious diseases at autopsy and to determine what extent an infectious process was involved in the patient's death. The present study was performed to analyze bacterial data of autopsy specimens in Siriraj Hospital during 1992-1999. Various autopsy specimens were cultured including heart blood, bronchus, lung, brain, cerebro-spinal fluid, pleural fluid, ascitic fluid, peritoneal fluid, liver, kidney, pericardial fluid, spleen and gall bladder From 781 autopsy specimens 502 (64.28%) were positive for bacterial pathogens. The five most common bacterial pathogens isolated from the present study were nonfermentative gram-negative rods followed by Klebsiella pneumoniae, Salmonella serogroup E, Escerichia coli and Acinetobacter anitratus, respectively. The ante mortem diagnosis by clinicians was correct 56% regarding to retrospectively analysis of septicemia/septic shock versus autopsy culture from heart blood

Bacteremia and antimicrobial susceptibilities in HIV-infected patients at Siriraj Hospital.

Bacterial infections in human immunodeficiency virus (HIV) infected patients may frequently develop into septicemia. Our study evaluated the bacterial pathogens isolated from hemocultures of HIV-infected patients at Siriraj Hospital and their antimicrobial susceptibility tests. The percentages of positive hemocultures were 24.64, 21.38, 23.88, and 28.46% in 1996, 1997, 1998, and 1999, respectively. Salmonella spp was the most pathogen isolated, followed by Escherichia coil (10.93%), Staphylococcus aureus (8.2%), coagulase-negative staphylococci (6.56%), nonfermentative gram-negative rods (6.01%), Pseudomonas aeruginosa (5.46%), Klebsiella pneumoniae (4.37%), and Enterobacter spp (4.37%). Salmonella, serogroup C was the most frequently isolated serogroup. It was sensitive to amoxicillin/clavulanate in 100%, ampicillin/sulbactam in 89%, cefazolin, cefuroxime, cefotaxime, ceftriaxone, ceftazidime, imipenem, gentamicin, amikacin, netilmycin, ofloxacin, and ciprofloxacin in 100%. The changing spectrum of bacteria and antimicrobial susceptibility patterns in HIV-1 infected patients may provide a guideline for the selection of appropriate drugs for treatment.

Salmonella meningitis and antimicrobial susceptibilities.

Meningitis caused by Salmonella species is not uncommon in many developing countries. Patients suspected of bacterial meningitis who were admitted to Siriraj Hospital were enrolled in this study during 1986-2001. There were only 19 cases of Salmonella meningitis. Salmonella serogroup D ranked first, followed by serogroup C, serogroup B and then serogroup H. Most patients were children under 1 year of age. The antimicrobial susceptibility pattern for Salmonella meningitis may provide a guideline for the selection of appropriate drug treatment.

Bacterial isolation and antimicrobial susceptibilities in patients with infective endocarditis.

Infective endocarditis is life-threatening and urgent treatment is needed. We review here 6217 patients with infective endocarditis admitted to Siriraj Hospital during a 20 year period, 1982-2001. In this retrospective study, we obtained our data from hemoculture results. Bacterial pathogens were found in only 834 patients (13.41%). Of the five most common pathogens, nonfermentative gram-negative rods (N.F.) ranked first (20.94%), followed by coagulase-negative staphylococci (12.47%), viridans streptococci (10.23%), Staphylococcus aureus (9.29%), and Escherichia coli (8.59%). Of the N.F., the sensitivities were: cefoperazone/sulbactam (86%), piperacillin/tazobactam (86%), meropenem (84%), imipenem (83%), ceftazidime (78%), ofloxacin (85%), ciprofloxacin (71%), and co-trimoxazole (71%).

Prevalence and antimicrobial susceptibility of Pseudomonas aeruginosa mucoid and non-mucoid type.

Pseudomonas aeruginosa is a leading cause of nosocomial infections. One thousand two hundred and twenty strains of mucoid and non-mucoid types of P. aeruginosa isolated from different patients were examined at Siriraj Hospital from January 2001-October 2003. The prevalences of P. aeruginosa mucoid type and non-mucoid type were 3.6% and 96.4%, respectively. Susceptibility testing was performed by Kirby-Bauer disk diffusion method as recommended by NCCLS. The isolates with mucoid phenotypes were more susceptible than the non-mucoid isolates. The antimicrobial susceptibility pattern of both types should provide guidelines for the selection of appropriate drugs for treatment.