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Updated: Sep 20, 2026
In Vitro Assay to Evaluate the Impact of Immunoregulatory Pathways on HIV-specific CD4 T Cell Effector Function
Published on: October 15, 2013
Bloodstream infections in late-stage acquired immunodeficiency syndrome patients evaluated by a lysis centrifugation
R C Rosas1, R Salomão, D A da Matta
1Hospital e Maternidade Santa Marcelina, São Paulo, SP, Brasil.
Abstract:
Opportunistic infections, which affect acquired immunodeficiency syndrome (Aids) patients, are frequently disseminated and may cause bloodstream infections (BSI). The aim of this study was to evaluate the main causes of BSI in Aids patients with advanced stage of the disease, with special emphasis on the identification of fungemia. During a 21 months period, all patients with Aids (CD4 < 200) and febrile syndrome admitted to 3 university hospitals were systematically evaluated. For each patient presenting fever, a pair of blood cultures was collected and processed by using a commercial lysis-centrifugation system. One hundred and eleven patients (75 males) with a mean age of 36 years (median 33 years) and mean CD4 count of 64 cells/ml were included. Among the 111 patients evaluated we documented 54 episodes of BSI, including 46 patients with truly systemic infections and 8 episodes considered as contaminants. BSI were caused by gram-positive bacteria (43%), fungi (20%), gram-negative bacteria (15%), mycobacteria (15%), and mixed flora (7%). The crude mortality rate of our patients was 39%, being 50% for patients with BSI and 31% for the others. In conclusion, BSI are a common related to systemic infections on Aids patients with advanced stage of disease and is associated with a high rate of mortality.
Insights
Bloodstream infections (BSI) are common in advanced Acquired Immunodeficiency Syndrome (AIDS) patients, often caused by bacteria and fungi. These infections significantly increase mortality rates in this vulnerable population.
Area of Science:
- Infectious Diseases
- Immunology
- Clinical Microbiology
Background:
- Opportunistic infections are prevalent in patients with Acquired Immunodeficiency Syndrome (AIDS).
- Disseminated infections, including bloodstream infections (BSI), pose a significant threat to AIDS patients with advanced disease.
- Fungal infections (fungemia) are a particular concern in this demographic.
Purpose of the Study:
- To determine the primary causes of bloodstream infections (BSI) in advanced Acquired Immunodeficiency Syndrome (AIDS) patients.
- To specifically investigate the incidence and role of fungemia in this patient group.
- To assess the impact of BSI on mortality in advanced AIDS patients.
Main Methods:
- A prospective study was conducted over 21 months in three university hospitals.
- 111 patients with AIDS (CD4 count < 200 cells/ml) and febrile syndrome were systematically evaluated.
- Blood cultures were collected and processed using a commercial lysis-centrifugation system to identify causative agents of BSI.
Main Results:
- 54 episodes of BSI were documented among 111 evaluated patients.
- The main causes of BSI were gram-positive bacteria (43%), fungi (20%), gram-negative bacteria (15%), and mycobacteria (15%).
- Patients with BSI had a 50% mortality rate, compared to 31% in those without BSI, contributing to an overall crude mortality of 39%.
Conclusions:
- Bloodstream infections are frequent in advanced AIDS patients with systemic infections.
- Fungal BSI represent a significant proportion of infections in this population.
- BSI in advanced AIDS patients are associated with a substantially high mortality rate.
