Aetiological spectrum of severe community-acquired pneumonia in HIV-positive patients from Pune, India

Mane, Arati; Gujar, Pankaj; Gaikwad, Shraddha; Bembalkar, Shilpa; Gaikwad, Sanjay; Dhamgaye, Tilak; Risbud, Arun

doi:10.4103/ijmr.ijmr_1590_16

Cited by 16 publications

(19 citation statements)

References 23 publications

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“…However, 52.9% and 41.2% of these isolates were resistant to erythromycin and tetracycline, respectively. This is in line with the study conducted in India, at which 50% resistance to erythromycin and 37.5% resistance to tetracycline [24].…”

Section: Discussionsupporting

confidence: 90%

“…Out of the S. aureus isolates, 52.9% were methicillin resistant. This nding was higher from the reports in Ethiopia (44.4%) [8] and from a study reported in India (37.5%) [24].…”

Section: Discussioncontrasting

confidence: 67%

“…In this study, E. coli, 11 (16.2%) was the second most common gram negative bacterial isolate which was similarly reported in Ethiopia (14.5%), Nepal (8.3%) and India (6.8%) [8,15,24]. From the gram positive bacteria, S. pneumoniae 2 (2.9%) was the second most commonly isolated bacteria and it is in line with the studies reported in Nepal (18.8%) and Nigeria (9.6%) [15,23].…”

Section: Discussionsupporting

confidence: 65%

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Bacterial Profile and Their Antibiotic Resistance Pattern Among HIV Patients Diagnosed with Pneumonia in Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Genetu¹,

Zenebe²

2020

Preprint

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Background: Bacterial pneumonia remains the major cause of morbidity and admissiondiagnosis among human immunodeficiency virus infected individuals. In the study area, data about the bacterial profile of pneumonia and their antimicrobial resistance pattern among people living with human immunodeficiency virus is limited. Hence, this study was aimed to estimate the prevalence of bacterial pneumonia, antibiotic resistance patterns of isolated bacteria and associated factors among HIV patients in Felege Hiwot Referral Hospital.Method: Hospital based cross-sectional study was conducted from February 15 to June 15, 2019. Sputum specimens were collected from 163 pneumonia presumptive HIV seropositive individuals. Data on socio-demographic characteristics and risk factors were also collected using a structured questionnaire. Blood, Chocolate, and MacConkey agar plates were used to grow the isolates. The isolated colonies were identified based on Gram Stain, colony morphology, hemolysis, and biochemical tests. The antimicrobial susceptibility test was performed using the modified Kirby-Bauer Disc Diffusion method. Descriptive and multivariate analyses were performed using SPSS version 23. P-value < 0.05 was considered statistically significant.Result: Out of 163 sputum samples, 68 (41.7%) were culture positive for common bacterial infections. The predominant bacterial isolates were Klebsiella pneumoniae, 19 (27.9%), and Staphylococcus aureus, 17 (25%). From multivariate analysis, age groups 18-29 (AOR = 5.4, 95 % CI: 1.26-23.35), age groups 30-39 (AOR = 3.8, 95% CI: 1.03-13.80), recent viral load greater than or equal to 150 copies/ml (AOR= 24.3, 95 % CI: 2.61-56.38), viral load less than 150 copies/ml (AOR= 5.1, 95% CI: 1.26-21.04), cigarette smoking (AOR=15.5, 95% CI: 1.61-48.59), and alcohol consumption (AOR=8.1, 95% CI: 2.76-23.51) were found to have statistically significant association with bacterial pneumonia. Out of the tested antibiotics 46 (70.8%) were resistant to cotrimoxazole and P. aeruginosa were 100% resistant to gentamycin and ceftazidime. Overall, 77.9% of the isolates were MDR.Conclusion: The study showed high prevalence of bacterial pneumonia and a high percentage of drug resistance including MDR in the study area. Therefore, we recommend that culture and antimicrobial susceptibility tests should be routinely performed for the selection of appropriate treatment.

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Section: Discussionsupporting

confidence: 90%

“…Out of the S. aureus isolates, 52.9% were methicillin resistant. This nding was higher from the reports in Ethiopia (44.4%) [8] and from a study reported in India (37.5%) [24].…”

Section: Discussioncontrasting

confidence: 67%

Section: Discussionsupporting

confidence: 65%

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Bacterial Profile and Their Antibiotic Resistance Pattern Among HIV Patients Diagnosed with Pneumonia in Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Genetu¹,

Zenebe²

2020

Preprint

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“…The causative agent in VAP has been reported by Indian investigators to include Acinetobacter baumannii besides the above-named agents and most of these are multidrug resistant. 2,4,12,13,[15][16][17][18]27 A working knowledge of the causative agents is useful, as it helps in narrowing down the differential diagnoses.…”

Section: Imaging Appearancesmentioning

confidence: 99%

Imaging Approach to Pulmonary Infections in the Immunocompromised Patient

Grover

Antil

et al. 2022

Indian J Radiol Imaging

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Pulmonary infections are the major cause of morbidity and mortality in immunocompromised patients and almost one-third of intensive care unit patients with pulmonary infections belong to the immunocompromised category. Multiple organisms may simultaneously infect an immunocompromised patient and the overwhelming burden of mixed infections further predisposes critically ill patients to acute hypoxemic respiratory failure. Notwithstanding that lung ultrasound is coming into vogue, the primary imaging investigation is a chest radiograph, followed by thoracic CT scan. This review based on our experience at tertiary care teaching hospitals provides insights into the spectrum of imaging features of various pulmonary infections occurring in immunocompromised patients. This review is unique as, firstly, the imaging spectrum described by us is categorized on basis of the etiological infective agent, comprehensively and emphatically correlated with the clinical setting of the patient. Secondly, a characteristic imaging pattern is emphasized in the clinical setting-imaging-pattern conglomerate, to highlight the most likely diagnosis possible in such a combination. Thirdly, the simulating conditions for a relevant differential diagnosis are discussed in each section. Fourthly, not only are the specific diagnostic and tissue sampling techniques for confirmation of the suspected etiological agent described, but the recommended pharmaco-therapeutic agents are also enumerated, so as to provide a more robust insight to the radiologist. Last but not the least, we summarize and conclude with a diagnostic algorithm, derived by us from the characteristic illustrative cases. The proposed algorithm, illustrated as a flowchart, emphasizes a diagnostic imaging approach comprising: correlation of the imaging pattern with clinical setting and with associated abnormalities in the thorax and in other organs/systems, which is comprehensively analyzed in arriving at the most likely diagnosis. Since a rapid evaluation and emergent management of such patients is of pressing concern not only to the radiologist, but also for the general physicians, pulmonologists, critical care specialists, oncologists and transplant surgery teams, we believe our review is very informative to a wide spectrum reader audience.

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“…9 10 11 12 13 14 Rates of bacterial pneumonia increase as CD4 counts drop, 15 16 with a trend toward increased mortality among patients with bacteremic pneumococcal pneumonia at lower CD4 counts. 14 In addition, the increased risk of mortality from influenza in patients living with HIV (PLWH), 12 although attenuated, does not disappear completely with the use of ART; furthermore, Mycobacteria tuberculosis (MTB) remains a significant etiological cause of pneumonia 13 17 .…”

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confidence: 99%

HIV and COVID-19 Disease

Venturas

2023

Semin Respir Crit Care Med

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Despite effective antiretroviral therapy (ART), HIV infected individuals throughout the world remain at significant risk of respiratory infections and non-communicable disease. Severe disease from SARS-CoV-2 is associated with a hyperinflammatory phenotype which manifests in the lungs as pneumonia and in some cases can lead to acute respiratory failure. Progression to severe COVID-19 is associated with comorbid disease such as obesity, diabetes mellitus and cardiovascular disease, however data concerning the associated risks of HIV coinfection are still conflicting, with large population studies demonstrating poorer outcomes, whilst smaller, case-controlled studies showing better outcomes. Furthermore, underlying immunopathological processes within the lungs and elsewhere, including interactions with other opportunistic infections (OI), remain largely undefined. Nonetheless, new and repurposed anti-viral therapies and vaccines which have been developed are safe to use in this population, and anti-inflammatory agents are recommended with the caveat that the coexistence of opportunistic infections is considered and excluded. Finally, HIV infected patients remain reliant on good ART adherence practices to maintain HIV viral suppression, and some of these practices were disrupted during the COVID-19 pandemic, putting these patients at further risk for acute and long-term adverse outcomes.

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Aetiological spectrum of severe community-acquired pneumonia in HIV-positive patients from Pune, India

Cited by 16 publications

References 23 publications

Bacterial Profile and Their Antibiotic Resistance Pattern Among HIV Patients Diagnosed with Pneumonia in Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Bacterial Profile and Their Antibiotic Resistance Pattern Among HIV Patients Diagnosed with Pneumonia in Felege-Hiwot Referral Hospital, Bahir Dar, Northwest Ethiopia

Imaging Approach to Pulmonary Infections in the Immunocompromised Patient

HIV and COVID-19 Disease

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