Management of severe non-TB bacterial infection in HIV-infected adults

Abstract

Despite widespread antiretroviral therapy use, severe bacterial infections (SBI) in HIV-infected adults continue to cause significant morbidity and mortality globally. Four main pathogens account for the majority of documented SBI: Streptococcus pneumoniae, non-typhoidal strains of Salmonella enterica, Escherichia coli and Staphylococcus aureus. The epidemiology of SBI is dynamic, both in developing countries where, despite dramatic successes in antiretroviral therapy, coverage is far from complete, and in settings in both resource-poor and resource-rich countries where antiretroviral therapy failure is becoming increasingly common. Throughout the world, this complexity is further compounded by rapidly emerging antimicrobial resistance, making management of SBI very challenging in these vulnerable patients. We review the causes and treatment of SBI in HIV-infected people and discuss future developments in this field.

Knowledge and perceptions of antimicrobial resistance and antimicrobial stewardship among staff at a national cancer referral center in Uganda

“…with HIV have high rates of antibiotic exposure 31,32 and are at increased risk of developing infections with resistant bacteria. 32,33 The microbiology of febrile illness also varies by HIV status.…”

“…with HIV have high rates of antibiotic exposure 31,32 and are at increased risk of developing infections with resistant bacteria. 32,33 The microbiology of febrile illness also varies by HIV status. For example, in sub-Saharan Africa tuberculosis is a leading cause of sepsis among those with HIV.…”

Viral and bacterial coinfection as a global problem of modern medicine

“…К бактериальным возбудителям инвазивных бактериальных инфекций, помимо S. aureus, от-носятся Streptococcus pneumoniae, нетифоидные штаммы Salmonella enterica, Escherichia coli [72], а ВИЧ-инфекция становится основным фактором риска инвазивных бактериальных инфекций с ле-тальным исходом, особенно когда речь идет о та-ких бактериальных возбудителях, как нетифоид-ные сальмонеллы или пневмококк [66]. В тропи-ческих странах ассоциантами ВИЧ бактериальной природы нередко выступают паразитирующие в макрофагах бруцеллы (Brucella spp.)…”

Epidemiology and management of healthcare-associated bloodstream infections in non-neutropenic immunosuppressed patients: a review of the literature

“…Therefore, clinicians should have a low threshold for initiating parenteral antibiotics in HIV patients with fever. 49 Due to geographically varying distribution of bacteria and resistance patterns, empirical treatment should follow local data and guidelines. There are additional factors that should also be considered for the empirical treatment.…”

“…43,45 Therefore, depending on the local epidemiology, empirical use of glycopeptides or daptomycin can be considered in those settings. 49 In Africa and Southeast Asia, NTS show high prevalence of multidrug resistance, particularly to antibiotics regarded as first line in low resource settings, that is, ampicillin, chloramphenicol, and co-trimoxazole. 42 Therefore, ceftriaxone and ciprofloxacin are recommended for the initial treatment in Africa.…”