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Bacterial and fungal infections in patients with the acquired immunodeficiency syndrome
K V Rolston1, S Radentz, S Rodriguez
1M.D. Anderson Cancer Center, Houston, TX 77030.
Abstract:
Over a 14-month period, 136 episodes of bacterial and 26 episodes of fungal infection were identified from the microbiology records of 444 patients with acquired immunodeficiency syndrome (AIDS). The respective rates for infection were 31 of 100 admissions (bacterial) and 5 of 100 admissions (fungal). Contributory factors appeared to be therapy with antineoplastic agents, ganciclovir and zidovudine, resulting in neutropenia, corticosteroid therapy, and increased use of central venous catheters. Bacteria isolated most often were Staphylococcus spp., the Enterobacteriaceae, and Pseudomonas aeruginosa. Aspergillus spp. and Candida spp. were the common fungal pathogens. However, several unusual fungal organisms seem to be emerging as important pathogens and can cause disseminated infection. Appropriate and prompt antimicrobial therapy resulted in the resolution of most bacterial infections. Disseminated fungal infections were difficult to treat and responded less often.
Insights
Patients with acquired immunodeficiency syndrome (AIDS) frequently experienced bacterial and fungal infections. Contributing factors included specific therapies and central venous catheters, with fungal infections being harder to treat.
Area of Science:
- Infectious Diseases
- Immunology
- Microbiology
Background:
- Patients with acquired immunodeficiency syndrome (AIDS) are susceptible to opportunistic infections.
- Therapies for AIDS, including antineoplastic agents, ganciclovir, and zidovudine, can lead to neutropenia.
- Increased use of central venous catheters is a known risk factor for infections.
Purpose of the Study:
- To identify the incidence and types of bacterial and fungal infections in patients with AIDS.
- To explore potential contributing factors to these infections.
- To evaluate the treatment outcomes for bacterial and fungal infections in this patient population.
Main Methods:
- Retrospective analysis of microbiology records from 444 patients with AIDS over a 14-month period.
- Calculation of infection rates per 100 admissions for bacterial and fungal pathogens.
- Identification of common and emerging bacterial and fungal organisms.
Main Results:
- 136 bacterial and 26 fungal infections were identified.
- Bacterial infection rate was 31/100 admissions; fungal infection rate was 5/100 admissions.
- Common bacterial pathogens included Staphylococcus spp., Enterobacteriaceae, and Pseudomonas aeruginosa. Aspergillus spp. and Candida spp. were common fungi, with emerging unusual fungal pathogens noted.
Conclusions:
- Therapies like antineoplastic agents, ganciclovir, zidovudine, corticosteroids, and central venous catheters contribute to infection risk in AIDS patients.
- Bacterial infections were generally responsive to prompt antimicrobial therapy.
- Disseminated fungal infections presented treatment challenges and had lower response rates.