Untitled

Abstract

Two hundred and twenty-four episodes of Pseudomonas spp. complications that occurred in 179 consecutive patients with HIV infection were retrospectively reviewed. Pseudomonas spp. organisms were responsible for 11.6% of 1933 episodes of non-mycobacterial bacterial diseases (5.4% of 1072 episodes of sepsis), observed over an 8-year period; 20.7% of patients experienced disease relapses (45 episodes). These complications mostly involved lower airways (66 cases), urinary tract (53 episodes), and blood (34 cases), with Pseudomonas aeruginosa isolated in 161 episodes, and other Pseudomonas spp. in the remaining 63 cases. An advanced HIV disease was frequently present (as expressed by a prior diagnosis of AIDS, a low CD4+ lymphocyte count, and leukopenia-neutropenia). Indwelling intravascular and urinary catheters were often associated with bacteremia and urinary tract involvement, respectively. More than 60% of patients were given antibiotics and/or cotrimoxazole in the month preceding the onset of Pseudomonas spp. disease. Bacterial strains isolated from our HIV-infected patients showed a favorable sensitivity to piperacillin, ceftazidime, imipenem, amikacin, tobramycin, and ciprofloxacin. An adequate antimicrobial treatment led to clinical and microbiological cure in 73.2% of patients at the first episode, and in 22.3% more subjects after one or more relapses. A lethal outcome occurred in only eight patients of 179 (4.5%), suffering from a far advanced HIV disease; P. aeruginosa infection directly contributed to death in four cases (sepsis, and/or pneumonia). Nosocomial disease occurred in 46.4% of the 224 episodes, and was significantly related to a previous diagnosis of AIDS, concurrent neutropenia, the occurrence of sepsis or urinary tract infection, disease relapses, the involvement of non-aeruginosa Pseudomonas spp., and a lethal outcome, compared with community-acquired infection. Our experience (the largest reported to date) confirms that Pseudomonas spp. (including non-aeruginosa Pseudomonas spp. organisms) is responsible for remarkable morbidity and mortality among patients with HIV infection, and may pose relevant problems to clinicians and microbiologists involved in the care of HIV-infected patients.

Bacterial Bloodstream Infections in HIV-infected Adults Attending a Lagos Teaching Hospital

“…Invasive non-typhoid Salmonellae are endemic in sub-Sahara Africa, and it has been postulated that transmission between humans—both within and outside health facilities (community-acquired)—may be important ( 28 ). P. aerugnosa and other Pseudomonas have also been more frequently recognized as nosocomial bacteraemia in HIV-infected patients ( 29 ) and were reported to account for 12% in hospital patients in Italy ( 30 ). Only one of the blood samples cultured grew E. coli .…”

The Regulatory Repertoire of Pseudomonas aeruginosa AmpC ß-Lactamase Regulator AmpR Includes Virulence Genes

“…It is the leading pathogen in ventilator-associated pneumonia with a mortality rate of 40–60% [1]. P. aeruginosa is also a primary cause of urinary tract infections in the US and Europe [2], wound infections leading to bacteremia with one-third to two-thirds mortality rate [3], [4], pulmonary infections including cystic fibrosis (CF) [5], lung cancer patients [6] and in pediatric and adult AIDS patients [7]. Inability to eradicate the infection is partly due to intrinsic and acquired antibiotic resistance of P. aeruginosa .…”

A Novel RNase 3/ECP Peptide for Pseudomonas aeruginosa Biofilm Eradication That Combines Antimicrobial, Lipopolysaccharide Binding, and Cell-Agglutinating Activities

“…In particular, P. aeruginosa is one of the most frequent causes of ventilator-associated pneumonia and catheter-related bloodstream infections (3,4). Patients with acquired immune deficiency syndrome (AIDS), burn wounds, or cystic fibrosis have a high risk of developing a serious infection, and this increased risk is related to a high death rate (5)(6)(7). P. aeruginosa can acquire resistance to certain antibiotics and, most importantly, is also able to form biofilms on inert surfaces such as medical devices of internal and external use.…”