Bloodstream Infections among HIV-Infected Outpatients, Southeast Asia
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 signific...
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| Published in | Emerging infectious diseases Vol. 16; no. 10; pp. 1569 - 1575 |
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| Main Authors | , , , , , , , , , , , , , , |
| 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 | |
| Online Access | Get full text |
| ISSN | 1080-6040 1080-6059 1080-6059 |
| DOI | 10.3201/eid1610.091686 |
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| Abstract | 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. |
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| AbstractList | 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.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. 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. 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. |
| Audience | Professional Academic |
| Author | McCarthy, Kimberly D. Tasaneeyapan, Theerawit Udomsantisuk, Nibondh Kimerling, Michael E. Buntheoun, Eng Teeratakulpisarn, Nipat Dung, Nguyen H. Monkongdee, Patama Phanuphak, Praphan Cain, Kevin P. Sculier, Delphine Yen, Nguyen T.B. Lan, Nguyen T.N. Varma, Jay K. Keo, Chantary |
| Author_xml | – sequence: 1 givenname: Jay K. surname: Varma fullname: Varma, Jay K. – sequence: 2 givenname: Kimberly D. surname: McCarthy fullname: McCarthy, Kimberly D. – sequence: 3 givenname: Theerawit surname: Tasaneeyapan fullname: Tasaneeyapan, Theerawit – sequence: 4 givenname: Patama surname: Monkongdee fullname: Monkongdee, Patama – sequence: 5 givenname: Michael E. surname: Kimerling fullname: Kimerling, Michael E. – sequence: 6 givenname: Eng surname: Buntheoun fullname: Buntheoun, Eng – sequence: 7 givenname: Delphine surname: Sculier fullname: Sculier, Delphine – sequence: 8 givenname: Chantary surname: Keo fullname: Keo, Chantary – sequence: 9 givenname: Praphan surname: Phanuphak fullname: Phanuphak, Praphan – sequence: 10 givenname: Nipat surname: Teeratakulpisarn fullname: Teeratakulpisarn, Nipat – sequence: 11 givenname: Nibondh surname: Udomsantisuk fullname: Udomsantisuk, Nibondh – sequence: 12 givenname: Nguyen H. surname: Dung fullname: Dung, Nguyen H. – sequence: 13 givenname: Nguyen T.N. surname: Lan fullname: Lan, Nguyen T.N. – sequence: 14 givenname: Nguyen T.B. surname: Yen fullname: Yen, Nguyen T.B. – sequence: 15 givenname: Kevin P. surname: Cain fullname: Cain, Kevin P. |
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| Keywords | Nosocomial infection Prevalence Mycology Retroviridae Mycobacterial infection Lentivirus Care Infection Virus Treatment Tuberculosis Risk factor Bacteriosis Antiviral Bacteria Ambulatory Hospital Human immunodeficiency virus Hygiene |
| Language | English |
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| SubjectTerms | 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 |
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| Title | Bloodstream Infections among HIV-Infected Outpatients, Southeast Asia |
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