Gram-negative bacillary bacteremia in human immunodeficiency virus type 1-infected children.
Pediatr Infect Dis J
; 19(2): 122-8, 2000 Feb.
Article
de En
| MEDLINE
| ID: mdl-10693998
ABSTRACT
BACKGROUND:
HIV-infected children are particularly susceptible to serious bacterial infections including Gram-negative bacillary bacteremia (GNB). However, the information available on GNB in these children is limited.METHODS:
Retrospective review of hospital charts of HIV-infected children with GNB diagnosed between 1980 and 1997. The association between bacteremic episodes, degree of immunosuppression, HIV severity, medical treatment and clinical outcome was assessed.RESULTS:
Of 680 HIV-infected children, 72 (10.6%) had 95 episodes of GNB. Statistical analyses were restricted to data from the first episode. The mean age (+/-SD) at diagnosis of GNB was 2.5 +/- 2.7 years (median, 1.6). The predominant organisms were Pseudomonas aeruginosa (26.4%), nontyphoidal Salmonella (15.3%), Escherichia coli (15.3%) and Haemophilus influenzae (12.5%). The relative frequency, per 5-year interval, of P. aeruginosa bacteremia steadily increased from 13% during 1980 through 1984 to 56% during 1995 through 1997. There were no cases of H. influenzae bacteremia after January 1, 1990. Eighty percent of GNB developed in children with AIDS and 72.2% developed in those with severe immunosuppression. Hypogamma-globulinemia and neutropenia were present in only 4.9 and 10.4% of first episodes, respectively. The overall case-fatality rate of GNB was 43.0%, and in children younger than 12 months it was 54.2%.CONCLUSIONS:
A diagnosis of AIDS and/or severe immunosuppression was associated with increased risk of GNB, especially among younger children. Because of the high mortality of GNB, a broad spectrum antimicrobial therapy that effectively covers these organisms should be promptly instituted when bacteremia is suspected in HIV-infected children.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Infections à VIH
/
VIH-1 (Virus de l'Immunodéficience Humaine de type 1)
/
Infections bactériennes à Gram négatif
/
Bactériémie
Type d'étude:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Child
/
Child, preschool
/
Humans
/
Infant
Langue:
En
Journal:
Pediatr Infect Dis J
Sujet du journal:
DOENCAS TRANSMISSIVEIS
/
PEDIATRIA
Année:
2000
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique