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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Does HIV status affect the aetiology, bacterial resistance patterns and recommended empiric antibiotic treatment in adult patients with bloodstream infection in Cambodia?
Tropical Medicine and International Health, Volume 18, No. 4, Year 2013
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Description
Objective: The microbiologic causes of bloodstream infections (BSI) may differ between HIV-positive and HIV-negative patients and direct initial empiric antibiotic treatment (i.e. treatment before culture results are available). We retrospectively assessed community-acquired BSI episodes in adults in Cambodia according to HIV status for spectrum of bacterial pathogens, antibiotic resistance patterns and appropriateness of empiric antibiotics. Methods: Blood cultures were systematically performed in patients suspected of BSI in a referral hospital in Phnom Penh, Cambodia. Data were collected between 1 January 2009 and 31 December 2011. Results: A total of 452 culture-confirmed episodes of BSI were recorded in 435 patients, of whom 17.9% and 82.1% were HIV-positive and HIV-negative, respectively. Escherichia coli accounted for one-third (n = 155, 32.9%) of 471 organisms, with similar rates in both patient groups. Staphylococcus aureus and Salmonella cholereasuis were more frequent in HIV-positive vs. HIV-negative patients (17/88 vs. 38/383 (P = 0.02) and 10/88 vs. 5/383 (P < 0.001)). Burkholderia pseudomallei was more common in HIV-negative than in HIV-positive patients (39/383 vs. 2/88, P < 0.001). High resistance rates among commonly used antibiotics were observed, including 46.6% ceftriaxone resistance among E. coli isolates. Empiric antibiotic treatments were similarly appropriate in both patient groups but did not cover antibiotic-resistant E. coli (both patient groups), S. aureus (both groups) and B. pseudomallei (HIV-negative patients). Conclusion: The present data do not warrant different empiric antibiotic regimens for HIV-positive vs. HIV-negative patients in Cambodia. The overall resistance rates compromise the appropriateness of the current treatment guidelines. © 2013 Blackwell Publishing Ltd.
Authors & Co-Authors
Phe, Thong
Cambodia, Phnom Penh
Sihanouk Hospital Center of Hope
Vlieghe, Erika R.
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Reid, Tony
Belgium, Brussels
Medecins Sans Frontieres, Brussels
Harries, Anthony David
France, Paris
International Union Against Tuberculosis and Lung Disease
United Kingdom, London
London School of Hygiene & Tropical Medicine
Lim, Kruy
Cambodia, Phnom Penh
Sihanouk Hospital Center of Hope
Thai, Sopheak
Cambodia, Phnom Penh
Sihanouk Hospital Center of Hope
de Smet, Birgit
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Kham, Chun
Cambodia, Phnom Penh
Sihanouk Hospital Center of Hope
van Griensven, Johan
Cambodia, Phnom Penh
Sihanouk Hospital Center of Hope
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Jacobs, Jan Adriaan
Belgium, Antwerpen
Prins Leopold Instituut Voor Tropische Geneeskunde
Statistics
Citations: 13
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1111/tmi.12060
ISSN:
13653156
Research Areas
Health System And Policy
Infectious Diseases