Elevated prevalence of multidrug-resistant gram-negative organisms in HIV positive men

Reinheimer, Claudia; Keppler, Oliver T.; Stephan, Christoph; Wichelhaus, Thomas A.; Friedrichs, I.; Kempf, Volkhard A. J.

doi:10.1186/s12879-017-2286-z

Cited by 14 publications

(6 citation statements)

References 31 publications

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“…There are studies that showed a higher frequency of colonization by multidrug resistant bacteria in HIV patients, suggesting possible sexual transmission of these bacteria. [36] Our study did not find a difference between HIV and non-HIV patients in the colonization rate by carbapenem-resistant Enterobacteriaceae in HAI caused by MDROs.…”

Section: Discussioncontrasting

confidence: 53%

Impact of human immunodeficiency virus infection on mortality of patients who acquired healthcare associated-infection in critical care unit

Lima

Borges²,

Joelsons³

et al. 2019

Medicine

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To evaluate 30-day mortality in human immunodeficiency virus (HIV) and non-HIV patients who acquired a healthcare-associated infection (HAI) while in an intensive care unit (ICU), and to describe the epidemiological and microbiological features of HAI in a population with HIV. This was a retrospective cohort study that evaluated patients who acquired HAI during their stay in an Infectious Diseases ICU from July 2013 to December 2017 at a teaching hospital in Brazil. Data were obtained from hospital infection control committee reports and medical records. Statistical analysis was performed using SPSS and a multivariate model was used to evaluate risk factors associated with 30-day mortality. Epidemiological, clinical, and microbiological characteristics of HAI in HIV and non-HIV patients and 30-day mortality were also evaluated. Among 1045 patients, 77 (25 HIV, 52 non-HIV) patients acquired 106 HAI (31 HIV, 75 non-HIV patients). HIV patients were younger (45 vs 58 years, P = .002) and had more respiratory distress than non-HIV patients (60.0% vs 34.6%, P = .035). A high 30-day mortality was observed and there was no difference between groups (HIV, 52.0% vs non-HIV, 54.9%; P = .812). Ventilator-associated pneumonia (VAP) was more frequent in the HIV group compared with the non-HIV group (45.2% vs 26.7%, P = .063), with a predominance of Gram-negative organisms. Gram-positive agents were the most frequent cause of catheter associated-bloodstream infections in HIV patients. Although there was a high frequency of HAI caused by multidrug-resistant organisms (MDRO), no difference was observed between the groups (HIV, 77.8% vs non-HIV, 64.3%; P = .214). Age was the only independent factor associated with 30-day mortality (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.01–1.1, P = .017), while diabetes mellitus (OR: 3.64, 95% CI: 0.84–15.8, P = .085) and the Sequential Organ-Failure Assessment (SOFA) score (OR: 1.16, 95% CI: 0.99–1.37, P = .071) had a tendency to be associated with death. HIV infection was not associated with a higher 30-day mortality in critical care patients with a HAI. Age was the only independent risk factor associated with death. VAP was more frequent in HIV patients, probably because of the higher frequency of respiratory conditions at admission, with a predominance of Gram-negative organisms.

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Section: Discussioncontrasting

confidence: 53%

Impact of human immunodeficiency virus infection on mortality of patients who acquired healthcare associated-infection in critical care unit

Lima

Borges²,

Joelsons³

et al. 2019

Medicine

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“…We designed an analytical cross-sectional study of HIV-positive (cases) and HIV-negative (controls) with one control per case. Prior research findings indicated that the prevalence of multidrug resistance amongst HIV-negative patients was 0.083 [15]. Assuming that the true prevalence rate of multidrug resistance in HIV-positive patients was 0.24, a sample size of 85 HIV-positive patients and 85 HIV-negative patients was required to reject the null hypothesis that these two proportions are equal with 0.8 power (Figure 1.)…”

Section: Sample Size Justificationmentioning

confidence: 99%

“…A reference strain of E. coli (ATCC-25922) was used as a control. Some studies define multidrug-resistant E.coli as having resistance to three families of drugs, while others define it as having resistance to cotrimoxazole, that is, having extended-spectrum beta-lactamase (ESBL) activity and resistance to third-and fourth-generation cephalosporins and fluoroquinolones with or without carbapenem resistance [15,19]. In this study, the E.coli isolates were predominantly resistant to cotrimoxazole; therefore, we defined multidrug resistance for our analysis as resistance to aminoglycosides and fluoroquinolones, which are amongst the main drugs of choice in the treatment of infection due to E. coli in this setting.…”

Section: Antimicrobial Susceptibility Testmentioning

confidence: 99%

Escherichia coli Antimicrobial Susceptibility Reduction amongst HIV-Infected Individuals at the University Teaching Hospital, Lusaka, Zambia

Chabala

Madubasi

Mutengo

et al. 2020

IJERPH

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Increased antimicrobial resistance among Human Immunodeficiency Virus (HIV)-infected individuals to commonly used antibiotics in the treatment of gastroenteritis is a public health concern, especially in resource-limited settings. We set out to compare the antimicrobial susceptibility pattern of Escherichia coli (E. coli) isolates from HIV-infected and HIV-uninfected individuals at a tertiary hospital in Lusaka, Zambia. An analytical cross-sectional study was conducted at the University Teaching Hospital from May 2019 to August 2019. Stool samples were screened, and 79 HIV-infected individuals matched by age and sex with 84 HIV-uninfected individuals that presented with E. coli associated gastroenteritis were studied. Demographics were collected from the Laboratory Information System (LIS) and stool samples were collected in a sterile leak-proof container. Samples were cultured and only those where E. coli was isolated were included in the study and tested for antimicrobial susceptibility by the Kirby–Bauer disk diffusion technique. HIV-positive individuals were 3 times (adjusted odds ratio (AOR) = 3.17; 95% CI (1.51, 6.66); p < 0.001) more likely to be resistant to quinolones compared with their HIV-negative counterparts. Similarly, HIV-positive individuals were almost 4 times (AOR = 3.97, 95% CI (1.37, 11.46); p = 0.011) more likely to have multidrug-resistant E. coli compared with those who were HIV-negative. HIV infection was associated with reduced E. coli susceptibility to commonly used antibiotics, and most cases showed resistance.

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“…Ce défi croissant peut s'expliquer entre autres par le portage fécal, largement rapporté, des bactéries productrices de BLSE chez les patients infectés par le VIH [ 22 ], probablement due à la pression sélective liée au recours à la prophylaxie au cotrimoxazole d'une part et à la forte incidence d'infections bactériennes nécessitant une antibiothérapie chez le PVVIH d'autre part. Étant donné que les carbapénèmes sont devenus les molécules de choix contre les bactéries multirésistantes, des cas de résistance à ces molécules sont de plus en plus rapportés [ 4 , 17 ]. Dans notre observation, les Pseudomonas sp étaient les principaux (22,2%) germes résistants aux carbapénèmes.…”

Section: Discussionunclassified

Profils de sensibilité aux antibactériens des isolats sanguins chez 74 patients infectés par le VIH hospitalisés à la clinique des maladies infectieuses et tropicales du CHU de Fann, Dakar de 2013 à 2016.

Wembulua

Lakhe²,

Mbaye³

et al. 2021

Médecine Tropicale Et Santé Internationale - Bulletin

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Résumé Introduction La bactériémie est associée à une létalité élevée chez les patients infectés par le VIH (PVVIH). La prophylaxie au cotrimoxazole et le mésusage des antibiotiques favorisent la résistance antibactérienne. Seules quelques études ont examiné ce problème chez les PVVIH. Ainsi, l'objectif de cette étude était de décrire le profil de résistance des germes responsables des bactériémies dans cette population. Matériel et méthodes Il s'agit d'une étude rétrospective transversale et descriptive menée à la clinique des maladies infectieuses et tropicales du CHU de Fann de mars 2013 à décembre 2016. Les données ont été collectées à partir des dossiers des patients grâce à un questionnaire d'enquête préétabli. Résultats Soixante-quatorze cas de bactériémie ont été enregistrés, dont 51,4% chez les femmes. L'âge médian était de 45 ans [18-73 ans] et le taux moyen de CD4 de 83,3 cellules/μl. Les staphylocoques à coagulase négative étaient les plus isolés (14%) suivis d' Escherichia coli (10%) et de Klebsiella pneumoniae (10%). Les taux de résistance à la méthicilline pour les staphylocoques à coagulase négative et Staphylococcus aureus étaient respectivement de 35,7% (5/14) et 22% (2/9). Les souches productrices de BLSE étaient représentées par Escherichia coli 50% (5/10), Klebsiella pneumoniae 40% (4/10) et Enterobacter sp 25% (2/8). Les Pseudomonas sp étaient les principaux (22,2%) germes résistants aux carbapénèmes. Conclusion Les résultats de cette étude prônent la nécessité d'une surveillance continue de la résistance antibactérienne chez les PVVIH et l'antibiothérapie probabiliste s'appuyant sur les données de surveillance.

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Elevated prevalence of multidrug-resistant gram-negative organisms in HIV positive men

Cited by 14 publications

References 31 publications

Impact of human immunodeficiency virus infection on mortality of patients who acquired healthcare associated-infection in critical care unit

Impact of human immunodeficiency virus infection on mortality of patients who acquired healthcare associated-infection in critical care unit

Escherichia coli Antimicrobial Susceptibility Reduction amongst HIV-Infected Individuals at the University Teaching Hospital, Lusaka, Zambia

Profils de sensibilité aux antibactériens des isolats sanguins chez 74 patients infectés par le VIH hospitalisés à la clinique des maladies infectieuses et tropicales du CHU de Fann, Dakar de 2013 à 2016.

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