Pathogen spectrum of community acquired pneumonia in people living with HIV (PLWH) in the German CAPNETZ-Cohort.
Infection
; 52(1): 129-137, 2024 Feb.
Article
in En
| MEDLINE
| ID: mdl-37423969
ABSTRACT
OBJECTIVES:
The objective of this study was to identify the pathogen spectrum of community acquired pneumonia in people living with HIV (PLWH), and to compare it with a matched HIV negative group in order to reassess therapeutic strategies for PLWH.METHODS:
Seventy-three (n = 73) PLWH (median CD4 3-6 months before CAP 515/µl; SD 309) with community acquired pneumonia (CAP) were matched with 218 HIV-negative CAP controls in a prospective study design. Pathogen identifications used blood culture, samples from the upper and lower respiratory tract (culture and multiplex PCR) and urinary pneumococcal and legionella antigen test.RESULTS:
Although the vaccination rate among PLWH with CAP was significantly higher (pneumococcal vaccination 27.4 vs. 8.3%, p < 0.001; influenza vaccination 34.2 vs. 17.4%, p = 0.009), pneumococci were found most frequently as pathogen among both PLWH (n = 19/21.3%) and controls (n = 34/17.2%; p = 0.410), followed by Haemophilus influenzae (PLWH, n = 12/13.5%, vs. controls, n = 25 / 12.6%; p = 0.850). Staphylococcus aureus was found equally in 20.2 and 19.2% in PLWH and controls, but infection or colonization could not be distinguished. Mortality during 6-month follow-up was significantly higher for PLWH (5/73, or 6.8%) versus controls (3/218, or 1.4%), however with lower case numbers than previously reported. Typical HIV-associated pathogens such as Pneumocystis jirovecii were found only exceptionally.CONCLUSIONS:
Our study underscores the persistent clinical burden of CAP for PLWH. From pathogen perspective, empirical antibiotic treatment for CAP in PLWH on antiretroviral therapy should cover pneumococci and Haemophilus influenzae and may be adopted from valid common recommendations.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
Community-Acquired Infections
/
Pneumonia, Bacterial
/
Haemophilus Infections
Type of study:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limits:
Humans
Language:
En
Journal:
Infection
Year:
2024
Document type:
Article
Affiliation country:
Alemania