The importance of bacterial sepsis in intensive care unit patients with acquired immunodeficiency syndrome: Implications for future care in the age of increasing antiretroviral resistance

Rosenberg, Andrew; Seneff, Michael G.; Atiyeh, Lyna; Wagner, Randall P.; Bojanowski, Leody; Zimmerman, Jack E.

doi:10.1097/00003246-200103000-00013

Cited by 62 publications

(57 citation statements)

References 71 publications

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“…S. aureus) and fungi (e.g. dermatophytes from genus Trichophyton and yeasts from genus Candida) may be an etiological agents of skin and soft tissue infections [46][47][48][49][50]. Due to limited antimicrobial therapeutics options and chronic course of superficial infections, the extracts from fruits of Rumex sp., including especially R. confertus and also R. crispus, R. hydrolapathum and R. obtusifolius, may be regarded as alternative or adjunctive externally used herbal specimens in treatment of uncomplicated superficial skin and soft tissue infections.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial activity of the extracts from fruits of Rumex L. species

et al. 2011

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This study was designed primarily to investigate the antibacterial and antifungal activity of the extracts from fruits of six Rumex L. species: R. acetosa L., R. acetosella L., R. confertus Willd., R. crispus L., R. hydrolapathum Huds. and R. obtusifolius L. The 7 Grampositive and 7 Gram-negative bacteria strains and 5 fungal ones were tested by agar and broth dilution method. Determination of minimal inhibitory concentration (MIC) revealed that the extracts from R. confertus, R. crispus, R. hydrolapathum and R. obtusifolius exerted differential inhibitory effect on the growth of Gram-positive bacteria — staphylococci (MIC=62.5–125 µg/mL) and Gramnegative bacteria — Escherichia coli ATCC 3521, Proteus mirabilis, Pseudomonas aeruginosa (MIC=125→500 µg/mL); MIC values determined by agar dilution method were somewhat higher. The same extracts inhibited also the growth of fungi — Candida spp. or Trichophyton mentagrophytes ATCC 9533 (MIC=250–500 µg/mL), as found by agar dilution method. The total content of polyphenols (11.66–78.36 mg/g), anthracene derivatives (0.26–12.93 mg/g) and tannins (4.00–11.16%) was also determined.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial activity of the extracts from fruits of Rumex L. species

et al. 2011

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“…This lower mortality rate might be related to several factors, including younger age, lower prevalence of associated comorbidities and decreased inflammatory response, leading to a lower incidence of septic shock. 13,20,21 Neither the incidence of BSI sustained by S. pneumoniae in the cART era, nor the mortality rate, decreased significantly. 19 The most important factors related to high mortality rate remain low CD4 cell count and the severity of pneumococcal disease (e.g.…”

Section: Streptococcus Pneumoniaementioning

confidence: 97%

“…11 BSI are now a more frequent cause of ICU admission than Pneumocystis jiroveci pneumonia in HIV-infected patients. 12,13 Nontyphoid salmonella, Streptococcus pneumoniae, Escherichia coli and Staphylococcus aureus are the most important pathogens of BSI. Fungal and mycobacterial infections are less frequent but can have considerable clinical and economic impact.…”

Section: Introductionmentioning

confidence: 99%

Bloodstream infections in HIV-infected patients

2016

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In the combined antiretroviral therapy era, HIV-infected patients remain a vulnerable population for the onset of bloodstream infections (BSI). Worldwide, nontyphoid salmonellae, Streptococcus pneumoniae, Escherichia coli, Staphylococcus aureus and coagulase negative staphylococci are the most important pathogens. Intravenous catheter associated infection, skin-soft tissue infection and endocarditis are associated with Gram-positive bacteremia. Among the Gram-negative, nontyphoidal Salmonella have been previously correlated to sepsis. Other causes of BSI in HIVinfected patients are mycobacteria and fungi. Mycobacteria constitute a major cause of BSI in limited resource countries. Fungal BSI are not frequent and among them Cryptococcus neoformans is the most common life-threatening infection. The degree of immunosuppression remains the key prognostic factor leading to the development of BSI.

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“…Median leukocyte count was 4400 cells/mm 3 , median CD4 count was 34 cells/ mm 3 , and median viral load was 81,273 copies/mL (Table 1). Ten patients died, for a mortality rate of 12.1%.…”

Section: Clinical Datamentioning

confidence: 99%

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

Haddy

Richmond²,

Trapse³

et al. 2012

The Journal of the American Board of Family Medicine

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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.)

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The importance of bacterial sepsis in intensive care unit patients with acquired immunodeficiency syndrome: Implications for future care in the age of increasing antiretroviral resistance

Cited by 62 publications

References 71 publications

Antimicrobial activity of the extracts from fruits of Rumex L. species

Antimicrobial activity of the extracts from fruits of Rumex L. species

Bloodstream infections in HIV-infected patients

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

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