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Bacterial infection in the acquired immunodeficiency syndrome of children
Insights
Serious bacterial infections, including sepsis, are common in children with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex, leading to significant illness. Common culprits include Streptococcus pneumoniae and Haemophilus influenzae.
Area of Science:
- Pediatric Infectious Diseases
- Immunology
- HIV/AIDS Research
Background:
- Children with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) are susceptible to various infections.
- Understanding the spectrum and causative agents of bacterial infections in this population is crucial for clinical management.
Purpose of the Study:
- To investigate the incidence and characteristics of serious bacterial infections in a cohort of children with AIDS/ARC.
- To identify common pathogens and clinical presentations of bacterial infections, including sepsis and urinary tract infections.
Main Methods:
- Prospective follow-up of 46 children diagnosed with AIDS or ARC.
- Documentation and analysis of serious bacterial infections, sepsis episodes, and causative microorganisms.
- Correlation of infection types with clinical presentation and patient history (e.g., hospitalization, prior antibiotic use).
Main Results:
- 26 out of 46 children experienced at least one serious bacterial infection.
- 21 patients had 27 documented episodes of sepsis.
- Soft tissue infections were frequent; urinary tract infections often presented as diarrhea without sepsis, commonly caused by E. coli.
- Streptococcus pneumoniae, Haemophilus influenzae, and Salmonella sp. were frequently isolated pathogens.
- Enteric and nosocomial sepsis occurred primarily in hospitalized or previously treated patients.
Conclusions:
- Bacterial infections contribute significantly to morbidity in children with AIDS/ARC.
- The findings suggest potential alterations in humoral immunity associated with AIDS/ARC, predisposing to bacterial infections.
- Specific pathogens and clinical presentations highlight the need for targeted diagnostic and therapeutic approaches.
Abstract:
We have followed 46 children with acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related complex. Twenty-six patients had at least one episode of serious bacterial infection. Twenty-seven episodes of sepsis were documented in 21 patients. Soft tissue infection was common in both the presence and the absence of documented bacteremia. Urinary tract infection commonly presented as worsening diarrhea in the absence of sepsis. Organisms commonly isolated included Streptococcus pneumoniae, Haemophilus influenzae and Salmonella sp. Staphylococcal infection accompanied episodes of cellulitis/abscess. Escherichia coli commonly caused urinary tract infection in the absence of sepsis. Enteric and nosocomial sepsis was limited to hospitalized, instrumented patients or to individuals who had received prior antibiotic therapy as outpatients. We conclude that bacterial infection causes serious morbidity in acquired immunodeficiency syndrome and acquired immunodeficiency syndrome-related complex and may be further evidence for altered humoral immunity in the disorder.