Prevalence of <scp>HIV</scp> infection among burn patients: is there a relationship with patients' outcomes?

Salehi, Seyed Hamid; Kamran, Ali; Tabatabaeenezhad, Seyedeh Azam; Naderan, Mohammad; Shoar, Saeed

doi:10.1111/iwj.12555

Cited by 6 publications

(3 citation statements)

References 10 publications

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“… 21 , 23 The only exception here is in patients who have AIDS and severe burns where the reported mortality was 100%. 3 , 22 …”

Section: Discussionmentioning

confidence: 99%

“…21,23 The only exception here is in patients who have AIDS and severe burns where the reported mortality was 100%. 3,22 The current understanding with infection control specialists in our hospital is that the patients should restart their HIV medication at their local clinic when discharged. This is done to avoid patients having to change medications because clinics do not have the same medication as the provincial hospitals and this protocol hopes to ensure better compliance.…”

Section: Infections Contribute To Mortality In Severe Burnsmentioning

confidence: 99%

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Protocol for clinical diagnosis and empiric treatment of pulmonary tuberculosis in severely burned patients: observations and literature review

Kulenkampff

Kleintjes

Kotzee

et al. 2023

Scars, Burns & Healing

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Introduction Reactivation of pulmonary tuberculosis is a prevalent concomitant infection and cause for mortality in burns patients in Sub-Saharan Africa. First line laboratory diagnostic studies for pulmonary tuberculosis are often negative in these patients and if relied on, result in high mortality. The purpose of this report is to share our experience with a novel protocol of empiric treatment of clinically suspected pulmonary tuberculosis in severely burned patients with negative GeneXpert tests in a tertiary burns centre and to present a brief literature review on the topic. Methods A retrospective chart review of all patients, who sustained thermal injury with an inhalation component, with negative GeneXpert tests who were treated empirically for pulmonary tuberculosis over a five-year period (2015–2020) was performed. Additionally, a literature search was performed on Medline (PubMed), Cochrane and Google Scholar databases. Results Over the five-year period, 20 patients with suspected pulmonary tuberculosis and severe burns requiring ventilation were managed according to the protocol and all survived to discharge. The literature search identified six factors that explain the consequence of pulmonary tuberculosis in severely burned patients and provide a hypothesis for the negative laboratory studies encountered. Conclusion There was an improved outcome for patients with the clinical diagnosis of reactivation of pulmonary tuberculosis when they were started on empirical pulmonary tuberculosis treatment. There are several potential mechanisms that can contribute to reactivation of pulmonary tuberculosis in susceptible severely burned patients. The GeneXpert test should not be relied upon in these patients for a diagnosis, but rather all other clinical evidence should inform management. Lay Summary From the current literature evidence most patients who have severe burns complicated by a secondary infection known as pulmonary (lung) tuberculosis, die as a result. The purpose of this report is to share our experience with treatment of pulmonary tuberculosis during a five-year period, from 2015 to 2020, in a specialized adult tertiary burn center. Severely burned patients who were suspected of having pulmonary tuberculosis and received treatment despite having negative laboratory tests for pulmonary tuberculosis, had a better survival rate than expected. A brief literature review on the topic of pulmonary tuberculosis and severe burns was done to investigate causes for reactivation of pulmonary tuberculosis and negative laboratory studies in these patients. The literature search identified the following factors that can potentially affect the reactivation of pulmonary tuberculosis in severely burned patients: decreased immune system; secondary infections; low blood albumin(protein) levels; decreased clearance of bacteria from the airways, the development of pulmonary tuberculosis biofilms (capsules that protect the bacteria from chemicals and antibiotics) and the role of a fat molecule called phosphatidylinositol mannoside in pulmonary tuberculosis. In conclusion, the pulmonary tuberculosis test should not be relied upon in these patients, but rather all the clinical evidence such X-ray changes in association with difficulty to wean the patient off the ventilator should be used to inform treatment choice.

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“… 21 , 23 The only exception here is in patients who have AIDS and severe burns where the reported mortality was 100%. 3 , 22 …”

Section: Discussionmentioning

confidence: 99%

Section: Infections Contribute To Mortality In Severe Burnsmentioning

confidence: 99%

Protocol for clinical diagnosis and empiric treatment of pulmonary tuberculosis in severely burned patients: observations and literature review

Kulenkampff

Kleintjes

Kotzee

et al. 2023

Scars, Burns & Healing

View full text Add to dashboard Cite

show abstract

“…In Iran, the prevalence of HIV infection classifi ed as being concentrated epidemics due to low incidence in the general population (0.02%), and high prevalence among injecting drug users, 13.8%. 8,36 The comprehensive report on HIV in Pakistan revealed that the number of people living with HIV is estimated to be 130000, (0.1%). 37 Generally, HIV infection is rapidly diagnosed based on the presence or absence of HIV antibodies.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Co-infections in HIV/AIDS-positive Subjects: A Systematic Review and Meta-analysis

et al. 2018

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Background: Bacterial infections are the most common complications in people with HIV/AIDS. There has been no previous report on the prevalence of bacterial co-infections in Iranian HIV/AIDS-positive subjects. Aim: To evaluate the frequency of bacterial infections in hospitalized HIV/AIDS-infected patients in Iran. Materials and methods: Based on PRISMA guidelines, a computerized search in related data banks using relevant keywords was performed in both Persian and English languages for articles that were published until March 10, 2017. A total of 1118 original articles were systematically reviewed to identify eligible studies on the prevalence of bacterial co-infections in HIV/AIDS-infected patients from Iran. After screening for inclusion and exclusion criteria, we extracted data from 28 eligible articles for the meta-analysis. Results: The overall bacterial infection rate among Iranian HIV/AIDS-positive individuals was estimated to be 48.6%. Gastrointestinal disorders (59.5%) were the most frequent bacterial infections in this group of patients followed by bacterial lymphadenopathy (38.9%), TB infection (38.2%), bacterial pneumonia (31.2%), brucellosis (26.3%), skin infections (13.3%) and sexually transmitted infections (9.7%). The prevalence of other bacterial infections including endocarditis, sepsis and Staphylococcus aureus (S. aureus) were 10%, 9.1%, and 6.9%, respectively. Conclusion: The prevalence of a wide spectrum of bacterial co-infections, especially endemic infections, in Iranian HIV/AIDS-infected patients, is alarming and calls for urgent need to improve the currently applied diagnostic and preventive methods. In addition, timely treatment of these infections is pivotal to decrease the morbidity and mortality rates in HIV/AIDS-infected patients.

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The Effect of Human‐Immunodeficiency Virus Status on Outcomes in Penetrating Abdominal Trauma: An Interim Analysis

et al. 2018

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Prevalence of HIV infection among burn patients: is there a relationship with patients' outcomes?

Cited by 6 publications

References 10 publications

Protocol for clinical diagnosis and empiric treatment of pulmonary tuberculosis in severely burned patients: observations and literature review

Protocol for clinical diagnosis and empiric treatment of pulmonary tuberculosis in severely burned patients: observations and literature review

Bacterial Co-infections in HIV/AIDS-positive Subjects: A Systematic Review and Meta-analysis

The Effect of Human‐Immunodeficiency Virus Status on Outcomes in Penetrating Abdominal Trauma: An Interim Analysis

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