Bloodstream Infections among HIV-Infected Outpatients, Southeast Asia

• Published in: Emerging infectious diseases Vol. 16; no. 10; pp. 1569 - 1575
• Main Authors: Varma, Jay K., McCarthy, Kimberly D., Tasaneeyapan, Theerawit, Monkongdee, Patama, Kimerling, Michael E., Buntheoun, Eng, Sculier, Delphine, Keo, Chantary, Phanuphak, Praphan, Teeratakulpisarn, Nipat, Udomsantisuk, Nibondh, Dung, Nguyen H., Lan, Nguyen T.N., Yen, Nguyen T.B., Cain, Kevin P.
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.10.2010; Centers for Disease Control and Prevention
• Subjects: Adult; AIDS-Related Opportunistic Infections - epidemiology; AIDS-Related Opportunistic Infections - microbiology; Analysis; Antiviral agents; Asia, Southeastern - epidemiology; Bacteremia - epidemiology; Bacteremia - microbiology; bacteria; Bacteria - classification; Bacteria - isolation & purification; Biological and medical sciences; Blood; Cambodia - epidemiology; Care and treatment; CME; cryptoccoci; diagnosis; Female; Fungemia - complications; Fungemia - epidemiology; Fungemia - microbiology; Fungi - classification; Fungi - isolation & purification; HIV infection; HIV Infections - complications; HIV Infections - epidemiology; HIV Infections - virology; HIV patients; HIV/AIDS and other retroviruses; Humans; Infection; Male; Medical examination; Medical sciences; Miscellaneous; Mycobacterium tuberculosis - isolation & purification; Outpatients; Prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Salmonella; Thailand - epidemiology; Tuberculosis; Tuberculosis - epidemiology; Tuberculosis - microbiology; Tuberculosis and other mycobacteria; Vietnam - epidemiology; Asia, Southeastern; Vietnam; Cambodia; Thailand; Nosocomial infection; Prevalence; Mycology; Retroviridae; Mycobacterial infection; Lentivirus; Care; Infection; Virus; Treatment; Tuberculosis; Risk factor; Bacteriosis; Antiviral; Bacteria; Ambulatory; Hospital; Human immunodeficiency virus; Hygiene
• ISSN: 1080-6040; 1080-6059; 1080-6059
• DOI: 10.3201/eid1610.091686

Bloodstream infections (BSIs) are a major cause of illness in HIV-infected persons. To evaluate prevalence of and risk factors for BSIs in 2,009 HIV-infected outpatients in Cambodia, Thailand, and Vietnam, we performed a single Myco/F Lytic blood culture. Fifty-eight (2.9%) had a clinically significant BSI (i.e., a blood culture positive for an organism known to be a pathogen). Mycobacterium tuberculosis accounted for 31 (54%) of all BSIs, followed by fungi (13 [22%]) and bacteria (9 [16%]). Of patients for whom data were recorded about antiretroviral therapy, 0 of 119 who had received antiretroviral therapy for ≥14 days had a BSI, compared with 3% of 1,801 patients who had not. In multivariate analysis, factors consistently associated with BSI were fever, low CD4+ T-lymphocyte count, abnormalities on chest radiograph, and signs or symptoms of abdominal illness. For HIV-infected outpatients with these risk factors, clinicians should place their highest priority on diagnosing tuberculosis.