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Bacterial infection in children with HIV: a prospective study from Cape Town, South Africa
A T Westwood1, B S Eley, R D Gilbert
1Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa. westwood@ich.uct.ac.za
Insights
Bacterial infections are common in South African children with human immunodeficiency virus (HIV). Blood cultures are vital for identifying bacterial causes and guiding antibiotic treatment in hospitalized children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Invasive bacterial infections pose a significant threat to children with human immunodeficiency virus (HIV).
- Limited data exists regarding the epidemiology of bacterial infections in HIV-infected children in South Africa.
- Understanding the microbiological profile of these infections is crucial for effective management.
Purpose of the Study:
- To prospectively investigate the incidence and microbiological characteristics of bacterial infections in hospitalized HIV-infected children in South Africa.
- To determine the utility of blood cultures in identifying bacterial pathogens.
- To assess the antibiotic resistance patterns of common bacterial isolates.
Main Methods:
- Prospective study of 108 HIV-infected children hospitalized over one year.
- Collection and analysis of blood cultures from 136 presumed infective episodes.
- Identification of bacterial pathogens and antimicrobial susceptibility testing.
Main Results:
- Blood cultures were positive in 24.8% of episodes, with Streptococcus pneumoniae being the most common pathogen (14/30 positive cultures).
- One-third of Streptococcus pneumoniae isolates exhibited penicillin resistance.
- Acute lower respiratory tract infections were frequent (44%), with a bacterial etiology confirmed in 23.8% of these cases.
Conclusions:
- A substantial proportion of presumed infective episodes requiring hospitalization in young HIV-infected children are bacterial in origin.
- Blood culture is an effective diagnostic tool for identifying bacterial pathogens and informing antibiotic therapy.
- The findings highlight the need for vigilant monitoring and appropriate antibiotic strategies for bacterial infections in this vulnerable population.
Abstract:
Invasive bacterial infection in children infected with the human immunodeficiency virus (HIV) is common. South African data on this problem are limited. Over 1 year we prospectively studied 108 HIV-infected children hospitalized for 136 presumed infective episodes. Blood culture was positive in 24.8% of episodes. Streptococcus pneumoniae predominated (14/30 positive blood cultures); one-third of isolates showed resistance to penicillin. Acute lower respiratory tract infection accounted for 44% of clinical diagnoses, a bacterial cause being established for 23.8% of these. Age and stage of HIV infection did not influence the likelihood of a positive culture. A high proportion of presumed infective episodes requiring hospitalization of young HIV-infected children have a bacterial cause. Blood culture appears to be a useful method of obtaining the microbiological information required to focus antibiotic therapy.
