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Query: UMLS:C0004610 (bacteremia)
 13,199 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Staphylococcus aureus has been recognized as a common cause of bacteremia of such infections in human immunodeficiency virus type 1 (HIV-1)-seropositive patients. Some staphylococcal exotoxins are recognized as superantigens. We have found that superantigen toxic shock syndrome toxin-1 (TSST-1) brings about a high level of viral production in HIV-1-infected peripheral blood mononuclear cells (PBMCs) through their activation in vitro. The p24 antigen level in the culture supernatant markedly increased in the presence of TSST-1 at a concentration of 1 pg/ml or higher. Fluorescent-activated cell sorter analysis revealed that TSST-1 specifically activated CD4+ T lymphocytes. Although significant production of tumor necrosis factor alpha (TNF-alpha) was observed in uninfected PBMCs treated with TSST-1 after 96 h of incubation, much earlier (after 12 h of incubation) production of TNF-alpha was identified in HIV-1 infected PBMCs with or without TSST-1 treatment. The addition of anti-TNF-alpha antibody to the culture medium resulted in a dramatic decrease in HIV-1 replication. These results suggest that the enhanced replication of HIV-1 by TSST-1 in PBMCs is attributable mainly to the activation of CD4+ T lymphocytes and that the induction of TNF-alpha further enhances replication. Since the enhancement of HIV-1 replication by TSST-1 occurs in a concentration range of picograms per milliliter, the superantigen TSST-1 may play an important role in the pathogenesis and clinical course of HIV-1 infections.
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PMID:Superantigen toxic shock syndrome toxin-1 (TSST-1) enhances the replication of HIV-1 in peripheral blood mononuclear cells through selective activation of CD4+ T lymphocytes. 758 34

There is little information available on invasive group B Streptococcus (GBS) infection in pediatric patients older than 3 months of age. Review of infection control records at LeBonheur Children's Medical Center from January 1, 1986, to June 30, 1993, identified 143 patients with a positive GBS culture from normally sterile body fluid. Medical records of 18 (13%) patients > 3 months old with their first GBS infection were reviewed. Age range was 15 weeks to 18 years (median age, 13 months). Ten were black and 11 were girls. Five infants had a history of premature birth and 2 infants were infected with human immunodeficiency virus. The serotype distribution of 12 available GBS isolates was 4 type III, 2 each type V and Ia and 1 each type Ia/c, Ib/c, II and II/c. Bacteremia without a focus (9 patients) was the most common clinical manifestation. All 4 type III isolates were associated with bacteremia. One infant with human immunodeficiency virus infection had sepsis and bullous desquamation; a toxin-producing type V strain was isolated from her blood. Two adolescents with ventriculoperitoneal shunts had meningitis, including one whose cerebrospinal fluid also grew a type V strain. Other clinical manifestations were septic arthritis, endocarditis (Ia, II/c), central venous catheter (Ia/c) and ventriculostomy infections.
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PMID:Invasive group B streptococcal disease in children beyond early infancy. 760 8

To determine whether defects in mucosal immunity were associated with invasive disease caused by a mucosal pathogen, Streptococcus pneumoniae, levels of salivary immunoglobulins and nonspecific immune factors were compared in subjects with human immunodeficiency virus type 1 (HIV-1) infection and in HIV-1-seronegative subjects with and without pneumococcal bacteremia. The IgA2 subclass may be of particular importance because S. pneumoniae produces IgA1 protease, which cleaves IgA1 but not IgA2. Levels (37-56 micrograms/mL) and proportions (11%-17%) of IgA2 were similar among groups. Serotype-specific capsular salivary IgA was present in a minority of patients with acute bacteremia. Levels of lactoferrin were increased with bacteremia. Neither selective mucosal IgA2 deficiency nor impaired nonspecific upper respiratory mucosal responses were associated with invasive pneumococcal disease during HIV-1 infection; thus, other defects in mucosal cellular responses and systemic immunity may predispose HIV-1-infected patients to invasive pneumococcal disease.
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PMID:Impact of Streptococcus pneumoniae bacteremia and human immunodeficiency virus type 1 on oral mucosal immunity. 762 7

The aims of this retrospective study were to review the frequency and patterns of bacterial sepsis in children infected with human immunodeficiency virus. The charts of 233 human immunodeficiency virus-infected children cared for during a 10-year period in 4 tertiary hospitals in Madrid were reviewed. There were 43 episodes of sepsis in 31 (13%) children. Twenty of them had acquired immunodeficiency syndrome, 10 were class PA2 and 1 was class P1B. The most common organisms recovered were: nontyphoidal Salmonella, 10 cases (23%); Streptococcus pneumoniae, 9 cases (21%); Staphylococcus epidermidis, 6 cases (14%); Escherichia coli, 5 cases (12%); Enterococcus faecalis, 4 cases (9%); Campylobacter jejuni, 2 cases (5%). In 28 episodes of bacteremia there were other sites of associated infection: pneumonia, 6 cases; urinary tract infection (UTI), 5 cases; gastrointestinal disease, 4 cases; catheter-related bacteremia, 12 cases. Eight patients had more than 1 episode of bacteremia. The rate of complications was high: 6 children had septic shock; and 2 of them developed disseminated intravascular coagulation. There was 1 death directly related to sepsis.
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PMID:Sepsis in children with human immunodeficiency virus infection. The Madrid HIV Pediatric Infection Collaborative Study Group. 766 58

The authors report the case of a woman affected by disseminated infection caused by Mycobacterium bovis, without risk exposure and immunodeficiency. There were chest and urinary localisations and bacteremia. Usually, M bovis is responsible of chest tuberculosis, in patients with professional exposure. Disseminated forms usually affect patients with immunodeficiency. Bacteria may be responsible of about 1% of tuberculosis, but real frequency is not known, because of its non specific report.
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PMID:[Disseminated Mycobacterium bovis tuberculosis in an aged female patient without HIV infection]. 770 5

We conducted a retrospective cohort study to evaluate the occurrence of bacteremia and associated mortality among hospitalized patients who were seropositive for the human immunodeficiency virus (HIV) and who developed fever and neutropenia following antineoplastic chemotherapy or for other reasons. Review of medical records revealed 224 episodes in 142 patients. Of these episodes, 57% occurred following antineoplastic chemotherapy, and 43% occurred under other circumstances. Members of the chemotherapy group had significantly less-advanced HIV disease, a lower mean absolute-neutrophil-count nadir, and a shorter duration of hospitalization. There was no difference between the two groups in the frequency of bacteremia or mortality due to all causes when they were compared by multivariate analysis. Statistically significant univariate and multivariate predictors of bacteremia included sepsis syndrome and concurrent infection. Predictors of mortality included sepsis syndrome, concurrent infection, bacteremia, and antimicrobial therapy. This study suggests that the cause of neutropenia in HIV-seropositive patients is not a predictor of the outcome of fever and neutropenic episodes. Instead, clinical presentation and concomitant illnesses have a greater impact on outcome for a patient.
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PMID:Outcome for hospitalized patients with fever and neutropenia who are infected with the human immunodeficiency virus. 774 43

Helicobacter cinaedi (formerly Campylobacter cinaedi) was first detected in the fecal flora of homosexual men. Since 1984, 11 case reports of H. cinaedi bacteremia have been published; most cases have presented as a nonspecific febrile illness in homosexual men infected with the human immunodeficiency virus (HIV). We identified seven additional cases of H. cinaedi bacteremia in two Denver hospitals within a 5-year period, which suggests that this illness is not as rare as was previously thought. Six of these cases of H. cinaedi bacteremia occurred in homosexual men who were infected with HIV. Four patients presented with the distinctive cutaneous manifestation of multifocal cellulitis, and two patients had monoarticular arthritis. Microbiological diagnosis of this infection was delayed by the slow growth of the bacterium in nonradiometric blood culture bottles. Although the patients' bacteremia was prolonged, their response to treatment was excellent. In contrast to campylobacter infections in HIV-infected patients, H. cinaedi bacteremia did not relapse after a course of effective therapy. H. cinaedi bacteremia should be suspected in HIV-infected individuals who present with an indolent febrile illness, particularly in the presence of multifocal cellulitis and/or arthritis.
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PMID:Multifocal cellulitis and monoarticular arthritis as manifestations of Helicobacter cinaedi bacteremia. 775 76

Retinitis due to cytomegalovirus (CMV) infection is a widely recognized complication of advanced disease due to human immunodeficiency virus type 1 (HIV-1). Less appreciated are other neurological manifestations of CMV infection in persons with AIDS. Dr. J. Allen McCutchan has comprehensively reviewed the various clinical presentations of CMV neurological disease as well as the methods of diagnosis, the neuropharmacology of available antiviral agents, the results of therapy, and the potential for prevention of these sequela of advanced immunosuppression. As the ability to prevent diseases such as Pneumocystis carinii pneumonia, bacteremia secondary to Mycobacterium avium, tuberculosis, serious fungal infections, and toxoplasma cerebritis is increasing, physicians must now treat more HIV-1-infected persons with CMV disease. This AIDS Commentary provides a timely update of the current state of our knowledge regarding this serious problem.
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PMID:Cytomegalovirus infections of the nervous system in patients with AIDS. 779 68

In cases of advanced infection with human immunodeficiency virus, mycobacterial blood cultures are frequently used to diagnose disseminated infection with the Mycobacterium avium complex (MAC). However, no prospectively validated guidelines exist for the use of such cultures. In this study, a two-part model for predicting MAC bacteremia was developed and then validated prospectively. First, a CD4+ cell count of < or = 50/microL was used to predict bacteremia. Then, among patients with < or = 50 CD4+ cells/microL, the documentation of fever on more than 30 days during the preceding 3 months, a hematocrit of < 30%, or a serum albumin concentration of < 3.0 g/dL was used to predict bacteremia. This model had a sensitivity of 89% and positive and negative predictive values of 30% and 98%, respectively, for the identification of patients with bacteremia. Had the model been applied to patients in this study, the number of blood cultures performed would have decreased by 61%, but 11% of the positive cultures would have been missed. In short, this model can predict MAC bacteremia and can potentially guide the use of mycobacterial blood cultures.
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PMID:Predicting Mycobacterium avium complex bacteremia in patients infected with human immunodeficiency virus: a prospectively validated model. 780 31

Haemophilus influenzae is a major bacterial pathogen in patients infected with the human immunodeficiency virus (HIV), although most infections with this organism occur in the respiratory tract. We describe an adult with HIV infection who presented with epididymo-orchitis due to H. influenzae. Eleven prior cases of H. influenzae epididymo-orchitis have been published, but all of these cases occurred in pediatric patients. Little is known about the prevalence of genitourinary tract infections caused by H. influenzae among adults. H. influenzae is a relatively rare cause of bacteremia in adults, but the frequency of H. influenzae bacteremia has been increasing among the HIV-positive population.
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PMID:Haemophilus influenzae epididymo-orchitis and bacteremia in a man infected with the human immunodeficiency virus. 780 47


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