Septicemia in Patients With AIDS Admitted to a University Health System: A Case Series of Eighty-Three Patients

Abstract

Background: Patients with AIDS incur higher rates of infection than the general population. However, little evidence exists to guide family physicians in selecting antibiotics for initial empiric therapy for suspected septicemia.Methods: We recorded the causative organisms of septicemia (defined here as bacteremia, fungemia, or both) in 83 patients with AIDS admitted to the teaching hospitals of the University of Louisville from 1996 to 2006. All patients fulfilled the requirements for a diagnosis of AIDS on the basis of the 1993 Centers for Disease Control criteria. In addition to the causative organism, demographic information, immunologic data, portal of entry, and mortality were collected.Results: Only 53% of the patients presented with fever and the median leukocyte count was 4400 cells/mm 3 . The most common organisms causing septicemia were, in decreasing order, methicillin-sensitive Staphylococcus aureus (MRSA; n ‫؍‬ 21; 21.4%), Mycobacterium avium complex (n ‫؍‬ 10; 10.2%), coagulase-negative staphylococci (n ‫؍‬ 9; 9.2%) and Streptococcus pneumoniae (n ‫؍‬ 9; 9.2%). Other pathogens included Escherichia coli, Pseudomonas aeruginosa, and MRSA. Polymicrobial septicemia was identified in 12 cases (14.5% of the episodes). The portals of entry of the organism were (in decreasing order) primary, lung, intravascular line, and skin. The types of organisms found in patients with primary septicemia patterned those found overall. The mortality rate was 12.1%.Conclusions: AIDS patients with septicemia may not present with the signs that would a non-AIDS patient with septicemia. On the basis of the range of organisms identified in this study, antibiotic coverage of AIDS patients with suspected septicemia, both in primary septicemia and septicemia overall, should take into consideration bacteremia with a wide range of organisms: Gram-positive organisms including MRSA and M. avium complex and Gram-negative organisms including Pseudomonas species. In addition, physicians should be aware that polymicrobial septicemia may be present. (J Am Board Fam Med 2012;25:318 -322.)

The Innate Immune Response in HIV/AIDS Septic Shock Patients: A Comparative Study

“…The HIV/AIDS septic patients exhibited infections due to bacteria, including Pseudomonas sp., Klebsiella sp., Mycobacterium tuberculosis , Histoplasma capsulatum and Cryptococcus neoformans , and this pattern was similar to those in other studies of sepsis and severe infections in the HIV population [27,28]. Although these discrepancies in the etiology of infection could lead to variable levels of inflammatory biomarkers [29], our results were similar between the HIV and non-HIV patients according to the responses of the innate immune system.…”

Profile of Bacteraemia and Fungemia in HIV/AIDS Patients with Sepsis

“…In this study, the HIV/AIDS patients with positive blood cultures were all male. This is similar to other studies that show men are more commonly affected by bloodstream infections than women (Bryce, 2014;Afessa, 2001;Haddy, 2012;Kiertiburanakul, 2012;Declercq, 2015;Buchacz, 2016). However, it is different from the studies performed by Oluyege in Nigeria, where the prevalence of female HIV / AIDS patients was higher than in men (Oluyege, 2015).…”

“…Mortality being not significantly different in polymicrobial or monomicrobial in HIV/AIDS patients is possibly due to the severe painful condition of HIV/AIDS patients, resulting in less significant amounts of bacteria in the blood as a cause of death. Septicemia whether monomicrobial or polymicrobial is a marker of severity of HIV/AIDS patients (Haddy, 2012).…”

Fatores de risco do diagnóstico de enfermagem: risco de infecção em pacientes com a Síndrome da Imunodeficiência Adquirida hospitalizados

“…Nível de Evidência Pubmed/medline 15 Caso-controle 2015 Taiwan IV Pubmed/medline 16 Ensaio Clínico 2012 EUA III Pubmed/medline 17 Transversal 2012 Brasil VI Pubmed/medline 28 Coorte 2009 Brasil IV Scopus 29 Retrospectivo 2001 EUA IV Scopus 20 Caso-controle 2001 Itália IV Pubmed/medline 21 Descritivo 1995 Espanha VI Cinahl 22 Descritivo 1994 EUA VI Pubmed/medline 23 Descritivo 1991 Dinamarca VI Pubmed/medline 24 Descritivo 1986 EUA VI Fonte: autoria própria, 2017.…”