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    Mar 06, 2021
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    Does HIV status affect the Aetiology, Bacterial Resistance Patterns and Recommended Empiric Antibiotic Treatment in adult patients with bloodstream infection in Cambodia?

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    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
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    Affiliation
    Infectious Diseases Department, Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia.
    Issue Date
    2013-01-07
    
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    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.
    URI
    http://hdl.handle.net/10144/279036
    DOI
    10.1111/tmi.12060
    PubMed ID
    23294446
    Language
    en
    ISSN
    1365-3156
    ae974a485f413a2113503eed53cd6c53
    10.1111/tmi.12060
    Scopus Count
    Collections
    HIV/AIDS

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