ABSTRACT
Opportunistic infections, which affect acquired immunodeficiency syndrome (Aids) patients, are frequently disseminated and may cause bloodstream infections (BSI). The aim of this study was to evaluate the main causes of BSI in Aids patients with advanced stage of the disease, with special emphasis on the identification of fungemia. During a 21 months period, all patients with Aids (CD4 < 200) and febrile syndrome admitted to 3 university hospitals were systematically evaluated. For each patient presenting fever, a pair of blood cultures was collected and processed by using a commercial lysis-centrifugation system. One hundred and eleven patients (75 males) with a mean age of 36 years (median 33 years) and mean CD4 count of 64 cells/ml were included. Among the 111 patients evaluated we documented 54 episodes of BSI, including 46 patients with truly systemic infections and 8 episodes considered as contaminants. BSI were caused by gram-positive bacteria (43%), fungi (20%), gram-negative bacteria (15%), mycobacteria (15%), and mixed flora (7%). The crude mortality rate of our patients was 39%, being 50% for patients with BSI and 31% for the others. In conclusion, BSI are a common related to systemic infections on Aids patients with advanced stage of disease and is associated with a high rate of mortality.
Subject(s)
AIDS-Related Opportunistic Infections/microbiology , Bacteremia/microbiology , Fungemia/microbiology , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Adult , Aged , CD4 Lymphocyte Count , Cross-Sectional Studies , Female , Gram-Negative Bacteria/classification , Gram-Positive Bacteria/classification , Humans , Male , Microbiological Techniques/methods , Middle Aged , Prevalence , Severity of Illness IndexSubject(s)
Antifungal Agents/therapeutic use , Aspergillosis/drug therapy , Aspergillosis/microbiology , Brain Abscess/drug therapy , Brain Abscess/microbiology , Diabetes Complications , Peptides, Cyclic , Peptides/therapeutic use , Aged , Amphotericin B , Aspergillosis/diagnosis , Brain Abscess/diagnosis , Caspofungin , Combined Modality Therapy , Contraindications , Craniotomy/methods , Diabetes Mellitus/diagnosis , Drug Hypersensitivity , Echinocandins , Female , Follow-Up Studies , Humans , Lipopeptides , Magnetic Resonance Imaging , Risk Assessment , Treatment OutcomeABSTRACT
Opportunistic infections, which affect acquired immunodeficiency syndrome (Aids) patients, are frequently disseminated and may cause bloodstream infections (BSI). The aim of this study was to evaluate the main causes of BSI in Aids patients with advanced stage of the disease, with special emphasis on the identification of fungemia. During a 21 months period, all patients with Aids (CD4 < 200) and febrile syndrome admitted to 3 university hospitals were systematically evaluated. For each patient presenting fever, a pair of blood cultures was collected and processed by using a commercial lysis-centrifugation system. One hundred and eleven patients (75 males) with a mean age of 36 years (median 33 years) and mean CD4 count of 64 cells/ml were included. Among the 111 patients evaluated we documented 54 episodes of BSI, including 46 patients with truly systemic infections and 8 episodes considered as contaminants. BSI were caused by gram-positive bacteria (43 percent), fungi (20 percent), gram-negative bacteria (15 percent), mycobacteria (15 percent), and mixed flora (7 percent). The crude mortality rate of our patients was 39 percent, being 50 percent for patients with BSI and 31 percent for the others. In conclusion, BSI are a common related to systemic infections on Aids patients with advanced stage of disease and is associated with a high rate of mortality