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- Title
Community-Acquired Bacterial Bloodstream Infections in HIV-Infected Patients: A Systematic Review.
- Authors
Huson, Michaëla A. M.; Stolp, Sebastiaan M.; van der Poll, Tom; Grobusch, Martin P.
- Abstract
HIV patients are at increased risk of bacterial bloodstream infections, which is reduced by antiretroviral therapy, and are especially at risk for nontyphoid salmonellae. Geographic differences in frequency of occurrence of the main pathogens are apparent, mainly for Streptococcus pneumoniae.Information on community-acquired bacterial bloodstream infections (BSIs) in individuals infected with human immunodeficiency virus (HIV) is limited. We conducted a systematic literature review. The case fraction of community-acquired bacterial BSIs in hospitalized patients is 20% and 30% in adults and children, respectively, compared to 9% in HIV-negative adults and children. Worldwide, the main pathogens of community-acquired BSI are nontyphoid salmonellae (NTS), Streptococcus pneumoniae, Escherichia coli, and Staphylococcus aureus, but regional differences are apparent, especially for S. pneumoniae. Compared to HIV-negative populations, HIV patients are particularly at risk to develop NTS bacteremia. Bacteremia incidence is related to immunosuppression, and antiretroviral therapy reduces the incidence of BSI in HIV patients (rate ratios, 0.63–0.02). Mortality rates varied between 7% and 46%. These results suggest that bacterial BSI is more likely to be found in HIV-positive than in HIV-negative patients upon hospitalization, and that causative pathogens vary by region.
- Subjects
COMMUNITY-acquired infections; BACTERIAL diseases; HIV infections; SYSTEMATIC reviews; HEALTH risk assessment; SALMONELLA
- Publication
Clinical Infectious Diseases, 2014, Vol 58, Issue 1, p79
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/cit596