Bloodstream infections in HIV-infected patients

Lucia Taramasso1, Paola Tatarelli1, Antonio Di Biagio1

  • 1a Infectious Diseases Unit, IRCCS AOU San Martino-IST, University of Genoa , Genoa , Italy.

Virulence
|March 8, 2016
PubMed

Insights

HIV patients on antiretroviral therapy are susceptible to bloodstream infections (BSI). Common culprits include nontyphoid Salmonella, Streptococcus pneumoniae, E. coli, and Staphylococcus aureus, with immunosuppression being a key risk factor.

Area of Science:

  • Infectious Diseases
  • HIV/AIDS Research
  • Microbiology

Background:

  • Patients with Human Immunodeficiency Virus (HIV) on combined antiretroviral therapy (cART) remain at high risk for bloodstream infections (BSI).
  • Identifying common pathogens and risk factors is crucial for managing BSI in this immunocompromised population.

Purpose of the Study:

  • To summarize the primary bacterial, mycobacterial, and fungal pathogens causing bloodstream infections in HIV-infected patients.
  • To highlight the association of specific infections with Gram-positive and Gram-negative bacteremia.
  • To underscore the role of immunosuppression as a prognostic factor for BSI development.

Main Methods:

  • Literature review and synthesis of epidemiological data on bloodstream infections in HIV patients.
  • Categorization of pathogens based on Gram staining (positive/negative), genus, and species.
  • Correlation of infection types with clinical conditions and patient immune status.

Main Results:

  • Nontyphoid Salmonella, Streptococcus pneumoniae, Escherichia coli, Staphylococcus aureus, and coagulase-negative staphylococci are leading causes of BSI worldwide in HIV patients.
  • Gram-positive bacteremia is linked to catheter-associated infections, skin-soft tissue infections, and endocarditis.
  • Mycobacteria are a significant cause of BSI in resource-limited settings, while Cryptococcus neoformans is the most common life-threatening fungal BSI.

Conclusions:

  • Despite cART, HIV patients are vulnerable to diverse BSIs.
  • Immunosuppression is the critical determinant for BSI onset and severity.
  • Targeted surveillance and management strategies are essential for preventing and treating BSIs in HIV-infected individuals.

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