Document Detail


Enterobacter spp. infections complicating the course of HIV disease.
MedLine Citation:
PMID:  11330368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Through a retrospective review of clinical and laboratory data of 2517 consecutive patients with HIV disease hospitalized since 1991, 13 patients were identified (0.52%), who suffered from a confirmed Enterobacter spp. infection (urinary tract disease in 7 cases, sepsis in 4 patients, and pneumonia in 2 cases). A severe immunodeficiency was recognized in all cases, as expressed by a mean CD4+ lymphocyte count <60 cells/microL, and frequently, a prior diagnosis of AIDS. Bloodstream infection proved linked to a lower mean CD4+ cell count, a more frequent occurrence of leukopenia-neutropenia, and nosocomial origin of the infecting pathogen. Hospital-acquired Enterobacter spp. disease was more frequent than community-acquired, and was significantly associated with leukopenia-neutropenia, and a diagnosis of AIDS. Antibiotic susceptibility assays showed a resistance rate to ampicillin and cephalothin involving >90% of tested strains, and a higher (but varied) sensitivity to other beta-lactams, aminoglycosides, fluoroquinolones, and cotrimoxazole. Adequate chemotherapy provided clinical and bacteriological success in all evaluated patients, in the absence of mortality or relapses. Only 34 episodes of HIV-associated Enterobacter spp. infection have been reported to date in 11 different literature studies. Our data point out that also Enterobacter spp. organisms may have an appreciable pathogenic potential in patients with HIV disease, especially in those with a low CD4+ lymphocyte count, leukopenia-neutropenia, who are hospitalized. Despite the unpredictable antibiotic susceptibility profile of these organisms, HIV-related Enterobacter spp. disease may be properly managed through rapid identification and timely and appropriate antimicrobial treatment.
Authors:
R Manfredi; A Nanetti; M Ferri; F Chiodo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of chemotherapy (Florence, Italy)     Volume:  13     ISSN:  1120-009X     ISO Abbreviation:  J Chemother     Publication Date:  2001 Apr 
Date Detail:
Created Date:  2001-05-01     Completed Date:  2001-09-06     Revised Date:  2009-08-04    
Medline Journal Info:
Nlm Unique ID:  8907348     Medline TA:  J Chemother     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  195-201     Citation Subset:  IM    
Affiliation:
Department of Clinical and Experimental Medicine, University of Bologna, S. Orsola Hospital, Italy. manfredi@med.unibo.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Bacterial Agents / therapeutic use
CD4 Lymphocyte Count
Drug Resistance, Microbial
Enterobacter / drug effects,  immunology,  pathogenicity*
Enterobacteriaceae Infections / drug therapy,  epidemiology,  etiology*
Female
HIV Infections / complications*
Humans
Immunocompromised Host
Incidence
Leukopenia
Male
Middle Aged
Neutropenia
Retrospective Studies
Risk Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

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