Introduction:
Human immunodeficiency virus (HIV) belongs to the Genus
Lentiviruses
and is made up of two main types HIV-1 and HIV-2 which are the causative agents of acquired immune deficiency syndrome (AIDS). It is well documented that HIV-1 infection is predominantly found, but HIV-2 infection has also been detected occasionally now and then.
Objective:
The objective of this study is to determine the seroprevalence of HIV-2 and dual infection in HIV-infected individuals along with the clinical presentation, co-infections, laboratory profile, and outcome of these patients.
Materials and Methods:
This descriptive cross-sectional study was carried out at a Tertiary Care Teaching Hospital for 2 years from August 2013 to July 2015, after obtaining approval from the Institutional Ethics Committee. Patients confirmed having HIV infection, as per the National AIDS Control Organization guidelines were included in the study. The sociodemographic pattern along with clinico-laboratory details and outcome were noted.
Results and Discussion:
In the present study, out of a total of 214 confirmed HIV-infected individuals, 2.8% (
n
= 6) were HIV-2 and 1.4% (
n
= 3) were dual infected where 40–50 years age group were most commonly affected. Males were more commonly affected than females in a ratio of 8:1. The most common presentation was fever (
n
= 5) followed by gastrointestinal (
n
= 5) symptoms. The most common opportunistic infection (OI) was tuberculosis (TB) (
n
= 4) followed by oral candidiasis (
n
= 2). Majority had anemia (
n
= 5) with raised erythrocyte sedimentation rate. Furthermore, majority (
n
= 7) showed improvement on discharge, whereas two (
n
= 2) left against medical advice and outcome is unknown.
Conclusion:
We conclude that the incidence of HIV-2 and dual infection does occur in our setup with males of older age group being more commonly affected where TB is the most common OI. Hence, clinicians should keep in mind that HIV-2 infection does occur and differentiating as HIV-1, HIV-2, or dual infection is important, to provide appropriate treatment which will result in decreased morbidity and mortality rates.
Background
Neonates born somewhere else (outborn) and treated in a referral centre have different microbiological profile. We report the microorganism’s profile and antimicrobial resistance (AMR) in blood culture proven sepsis in outborn neonates.
Methods
Culture positive neonatal sepsis from a neonatal unit of a referral institute catering to outborn neonates was studied over an 18 months duration. Data from the hospital information system were used to analyse the culture positivity rates, the spectrum of the microorganisms isolated and AMR pattern.
Results
Out of 5258 admitted neonates, 3687 blood samples were sent for suspect sepsis. The blood cultures were positive in 537 (14.6%) samples from 514 neonates. Gram-positive cocci (GPC) were the most common [240 (45%)] followed by gram-negative bacilli (GNB) [233 (43.4%)] and fungi [64 (11.9%)]. Coagulase negative staphylococcus (CONS) contributed to two-thirds of GPC followed by Klebsiella [93 (17.3%)] and Acinetobacter species [52 (9.7%)]. In 403 (75%) neonates, organisms grew in the samples sent at or within 24 h of admission. The case fatality rate was significantly higher in those with culture positive sepsis. The resistance to meropenem and imipenem was documented in 57.1% and 49.7%, respectively and 48% of the GNB was multidrug resistant.
Conclusions
CONS followed by Klebsiella species were the most common organisms isolated. Three-fourths of the neonates had organisms grown at or within 24 h from admission. More than half of the GNB were multidrug resistant. The case fatality rate was significantly higher in those with culture positive sepsis.
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