Risk Factors for Fungemia in Children Infected with Human Immunodeficiency Virus: A Case-Control Study

Abstract

To define the risk factors related to the occurrence of fungemia in children infected with human immunodeficiency virus (HIV), we performed a matched case-control study. During a 6-year period (1987-1993), fungemia developed in 22 (6.3%) of 347 HIV-infected children observed at the Pediatric Branch of the National Cancer Institute. Each of these 22 cases was matched by age and gender with three controls. Multiple logistic regression indicated that the best predictor of fungemia in this population was the presence of a central venous catheter placed for > 90 days (P < .00001), followed by a group of risk factors composed of 10 independent variables adjusted for a CD4 cell count of < 100/MicroL (P < .045). Those variables included treatment with more than three antibiotics, treatment with more than three parenteral antibiotics, > 30 days of antibiotic treatment, bacterial infections, > 30 days in the hospital, hypoalbuminemia, C3 (Centers for Disease Control and Prevention) classification of HIV infection, and malnourishment. We conclude that prolonged placement of central venous catheters is the most important risk factors for fungemia in HIV-infected children and that the risk of fungemia is further influenced by antibacterial therapy, catheter manipulation, and host response.

Fatal Fungemia due to Paracoccidioides lutzii

“…20 Other underlying diseases may also be involved and increase the risk of fungemia in human patients. 20,21 To the best of our knowledge, this study is the first to report a case of fungemia caused by P. lutzii in an immunocompetent patient, which distinguishes our case from the classical risk group. The criteria used here to define the patient as immunocompetent was based on absence of any underlying disease such as HIV, cancer, tuberculosis, and hepatitis.…”

Antimicrobial Activity Of Some Indian Medicinal Plants

“…This increase has been attributed to indiscriminate use of broad-spectrum antibiotics, immunosuppressive agent, intravenous catheters, organ transplantation and ongoing epidemics of HIV infection (Graybill, 1988;Ng, 1994;Dean and Burchard, 1996;Gonzalez et al, 1996). In addition, in developing countries, synthetic drugs are not only expensive and inadequate for the treatment of diseases but also often with adulterations and side effects.…”

Antioxidant and Antifungal Potential of Murraya Koenigii Leaves Extracts (Crude) and Essential Oil

“…This increase has made the use of broad spectrum antibiotics and immuno-suppressive agents indiscriminately. Synthetic drugs are not only expensive and inadequate for treatment of diseases but are often with serious side-effects 10 . Essential oils, the vast reservoir of secondary metabolites produced by aromatic and officinal plants are of specific interest due to potent biological activities 11 .…”