Does HIV status affect the Aetiology, Bacterial Resistance Patterns and Recommended Empiric Antibiotic Treatment in adult patients with bloodstream infection in Cambodia?

Hdl Handle:
http://hdl.handle.net/10144/279036
Title:
Does HIV status affect the Aetiology, Bacterial Resistance Patterns and Recommended Empiric Antibiotic Treatment in adult patients with bloodstream infection in Cambodia?
Authors:
Phe, Thong; Vlieghe, Erika; Reid, Tony; Harries, Anthony D; Lim, Kruy; Thai, Sopheak; De Smet, Birgit; Veng, Chhunheng; Kham, Chun; Ieng, Sovann; van Griensven, Johan; Jacobs, Jan
Journal:
Tropical Medicine & International Health : TM & IH
Abstract:
OBJECTIVE: The microbiologic causes of bloodstream infections (BSI) may differ between HIV-positive and HIV-negative patients and direct initial empiric antibiotic treatment (i.e. treatment before culture results are available). We retrospectively assessed community-acquired BSI episodes in adults in Cambodia according to HIV status for spectrum of bacterial pathogens, antibiotic resistance patterns and appropriateness of empiric antibiotics. METHODS: Blood cultures were systematically performed in patients suspected of BSI in a referral hospital in Phnom Penh, Cambodia. Data were collected between 1 January 2009 and 31 December 2011. RESULTS: A total of 452 culture-confirmed episodes of BSI were recorded in 435 patients, of whom 17.9% and 82.1% were HIV-positive and HIV-negative, respectively. Escherichia coli accounted for one-third (n = 155, 32.9%) of 471 organisms, with similar rates in both patient groups. Staphylococcus aureus and Salmonella cholereasuis were more frequent in HIV-positive vs. HIV-negative patients (17/88 vs. 38/383 (P = 0.02) and 10/88 vs. 5/383 (P < 0.001)). Burkholderia pseudomallei was more common in HIV-negative than in HIV-positive patients (39/383 vs. 2/88, P < 0.001). High resistance rates among commonly used antibiotics were observed, including 46.6% ceftriaxone resistance among E. coli isolates. Empiric antibiotic treatments were similarly appropriate in both patient groups but did not cover antibiotic-resistant E. coli (both patient groups), S. aureus (both groups) and B. pseudomallei (HIV-negative patients). CONCLUSION: The present data do not warrant different empiric antibiotic regimens for HIV-positive vs. HIV-negative patients in Cambodia. The overall resistance rates compromise the appropriateness of the current treatment guidelines.
Affiliation:
Infectious Diseases Department, Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia.
Issue Date:
7-Jan-2013
URI:
http://hdl.handle.net/10144/279036
DOI:
10.1111/tmi.12060
PubMed ID:
23294446
Language:
en
ISSN:
1365-3156
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorPhe, Thongen_GB
dc.contributor.authorVlieghe, Erikaen_GB
dc.contributor.authorReid, Tonyen_GB
dc.contributor.authorHarries, Anthony Den_GB
dc.contributor.authorLim, Kruyen_GB
dc.contributor.authorThai, Sopheaken_GB
dc.contributor.authorDe Smet, Birgiten_GB
dc.contributor.authorVeng, Chhunhengen_GB
dc.contributor.authorKham, Chunen_GB
dc.contributor.authorIeng, Sovannen_GB
dc.contributor.authorvan Griensven, Johanen_GB
dc.contributor.authorJacobs, Janen_GB
dc.date.accessioned2013-04-04T22:58:45Z-
dc.date.available2013-04-04T22:58:45Z-
dc.date.issued2013-01-07-
dc.identifier.citationDoes HIV status affect the aetiology, bacterial resistance patterns and recommended empiric antibiotic treatment in adult patients with bloodstream infection in Cambodia? 2013: Trop. Med. Int. Healthen_GB
dc.identifier.issn1365-3156-
dc.identifier.pmid23294446-
dc.identifier.doi10.1111/tmi.12060-
dc.identifier.urihttp://hdl.handle.net/10144/279036-
dc.description.abstractOBJECTIVE: The microbiologic causes of bloodstream infections (BSI) may differ between HIV-positive and HIV-negative patients and direct initial empiric antibiotic treatment (i.e. treatment before culture results are available). We retrospectively assessed community-acquired BSI episodes in adults in Cambodia according to HIV status for spectrum of bacterial pathogens, antibiotic resistance patterns and appropriateness of empiric antibiotics. METHODS: Blood cultures were systematically performed in patients suspected of BSI in a referral hospital in Phnom Penh, Cambodia. Data were collected between 1 January 2009 and 31 December 2011. RESULTS: A total of 452 culture-confirmed episodes of BSI were recorded in 435 patients, of whom 17.9% and 82.1% were HIV-positive and HIV-negative, respectively. Escherichia coli accounted for one-third (n = 155, 32.9%) of 471 organisms, with similar rates in both patient groups. Staphylococcus aureus and Salmonella cholereasuis were more frequent in HIV-positive vs. HIV-negative patients (17/88 vs. 38/383 (P = 0.02) and 10/88 vs. 5/383 (P < 0.001)). Burkholderia pseudomallei was more common in HIV-negative than in HIV-positive patients (39/383 vs. 2/88, P < 0.001). High resistance rates among commonly used antibiotics were observed, including 46.6% ceftriaxone resistance among E. coli isolates. Empiric antibiotic treatments were similarly appropriate in both patient groups but did not cover antibiotic-resistant E. coli (both patient groups), S. aureus (both groups) and B. pseudomallei (HIV-negative patients). CONCLUSION: The present data do not warrant different empiric antibiotic regimens for HIV-positive vs. HIV-negative patients in Cambodia. The overall resistance rates compromise the appropriateness of the current treatment guidelines.en_GB
dc.languageENG-
dc.language.isoenen
dc.rightsArchived on this site with the kind permission of Wiley-Blackwell, [url]http://www.blackwell-synergy.com/loi/tmi[/url]en_GB
dc.titleDoes HIV status affect the Aetiology, Bacterial Resistance Patterns and Recommended Empiric Antibiotic Treatment in adult patients with bloodstream infection in Cambodia?en
dc.contributor.departmentInfectious Diseases Department, Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia.en_GB
dc.identifier.journalTropical Medicine & International Health : TM & IHen_GB

Related articles on PubMed

All Items in MSF are protected by copyright, with all rights reserved, unless otherwise indicated.