Rongkavilit C, Rodriguez Z, Scott GB; Interscience Conference on Antimicrobial Agents and Chemotherapy.
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 1996 Sep 15-18; 192 (abstract no. I31).
University of Miami, Miami, FL.
To characterize incidence and clinical and immunological correlates of gram-negative bacilli bacteremia (GNB) in HIV-1 infected children, we performed a retrospective review of cases from August 1980 to February 1996. There were 87 episodes of GNB in 62 of 680 HIV-1 infected children (incidence of 9.1%). 21 patients had more than one episode of GNB. Mean age at diagnosis of GNB was 2.43 years (range 1 month-10.5 years). Leading organisms included Pseudomonas aeruginosa (23 in 87, 26.4%), Salmonella (14 in 87, 16.1%), Escherichia coli (14 in 87, 16.1%) and Hemophilus influenzae (10 in 87, 11.5%). 72% of GNB developed while patients were severely immunosuppressed (CDC immunologic category 3). 14 episodes were associated with pneumonia, 6 with lung abscess (found postmortem), 2 with meningitis (both were H. influenzae), and 10 with intravascular catheters. 95.4% of patients were not hypogammaglobulinemic and 90.8% were not neutropenic (ANC less than 1,000) prior to the bacteremia. Overall mortality rate of GNB was 40.3% 84.6% of deaths in children less than 2.5 years of age. 61.5% of deaths occurred prior to the year 1990. Trend of decreased mortality after 1990 was noted. An AIDS diagnosis and/or severe immunosuppression place a child with HIV at risk for GNB. Therefore, when bacteremia is suspected in a child with advanced HIV disease, broad spectrum coverage for gram-negative bacilli should be considered.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Bacillus
- Bacteremia
- Child
- Gram-Negative Bacteria
- Gram-Positive Bacteria
- HIV Infections
- HIV Seropositivity
- HIV-1
- Haemophilus Infections
- Haemophilus influenzae
- Humans
- Incidence
- Pseudomonas aeruginosa
Other ID:
UI: 102234980
From Meeting Abstracts