Related Experiment Videos
[Bacteremia caused by Pseudomonas aeruginosa in patients with AIDS]
E Bouza Santiago1, R Blázquez Garrido, M Rodríguez-Creixems
1Servicio de Microbiología y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid.
Abstract:
Severe infections caused by Pseudomonas aeruginosa are uncommon in patients infected with HIV. These infections are usually recurrent, bear a poor prognosis and their potential for nosocomial transmission is questioned. From May 1991 to December 1994, a total of 2,739 admissions were recorded at the VIH Unit in our hospital. Seven of those patients suffered 9 episodes of P. aeruginosa bacteremia (3.28 episodes/1,000 admissions). All cases were acquired nosocomially. The mean CD4 count was 30.7 cells/ml. Mortality associated with Pseudomonas aeruginosa bacteremia was 43%. With molecular typing techniques homologies over 98% were demonstrated for the two episodes in patient 4 and the episode in patient 3 (very close in time, 1993) and almost 99% between the isolate from patient 7 and the two isolates (identical) from patient 6. The other three isolates had relationship (to themselves and to the other isolates) lower than 97%. Our findings suggest that patient-to-patient transmission of severe infections caused by P. aeruginosa in patients with AIDS.
Insights
Severe Pseudomonas aeruginosa infections are rare in HIV patients but often recurrent and fatal. Molecular typing suggests patient-to-patient transmission of these nosocomial infections in acquired immunodeficiency syndrome (AIDS) patients.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Severe infections caused by Pseudomonas aeruginosa are uncommon in patients with Human Immunodeficiency Virus (HIV).
- These infections are typically recurrent, have a poor prognosis, and their potential for nosocomial transmission is often questioned.
- Patients with Acquired Immunodeficiency Syndrome (AIDS) are particularly vulnerable to opportunistic infections.
Purpose of the Study:
- To investigate the incidence, characteristics, and transmission patterns of Pseudomonas aeruginosa bacteremia in hospitalized HIV patients.
- To determine the mortality rate associated with P. aeruginosa bacteremia in this patient population.
- To assess the potential for nosocomial transmission using molecular typing techniques.
Main Methods:
- Retrospective analysis of 2,739 admissions to an HIV Unit from May 1991 to December 1994.
- Identification and characterization of P. aeruginosa bacteremia episodes.
- Molecular typing of bacterial isolates to assess genetic relatedness.
- Analysis of patient CD4 counts and clinical outcomes.
Main Results:
- Nine episodes of P. aeruginosa bacteremia occurred in seven HIV patients (3.28 episodes/1,000 admissions), all acquired nosocomially.
- The mean CD4 count of affected patients was 30.7 cells/ml.
- Mortality associated with P. aeruginosa bacteremia was 43%. Molecular typing revealed high homology (>98%) between isolates from different patients, suggesting transmission.
Conclusions:
- Nosocomial Pseudomonas aeruginosa bacteremia is a significant concern in severely immunocompromised HIV patients.
- Molecular evidence strongly suggests patient-to-patient transmission of P. aeruginosa within the hospital setting.
- Effective infection control measures are crucial to prevent the spread of these severe infections in vulnerable populations.