Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019693 (HIV)
 170,526 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chancroid caused by Haemophilus ducreyi has been described as a significantly predisposing factor of HIV heterosexual transmission in an endemic region of both diseases. The fastidious, H. ducreyi has been reported world wide with various antimicrobial susceptibility patterns. A high tendency of drug resistances has generally been found among isolates derived in Thailand. In this study, the plasmids of H. ducreyi were isolated and analysed from 63 clinically derived organisms. Twenty-nine out of 63 isolates (46%) revealed the same plasmid profiles. Plasmid DNA was further cloned into Escherichia coli and transformants were selected. A 3.6 kb plasmid (pCb) carrying ampicillin resistance was subsequently identified. The pCb conferred resistance to various beta-lactam antibiotics including penicillin G, carbenicillin, piperacillin, cefazolin, cefoperazone, ampicillin-sulbactam, and amoxicillin-clavulanate but not to cefoxitin. Co-resistance to streptomycin, chloramphenicol and tetracycline was not detected. Beta-lactamase gene was located on the major pCb fragment of EcoRI and AatII cutting.
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PMID:Episome profiles and mobilizable beta-lactamase plasmid in Haemophilus ducreyi. 1102 70

To assess the role of Moraxella catarrhalis complications in the setting of HIV disease, and to evaluate their occurrence and outcome according to several epidemiological, clinical, and laboratory parameters, the clinical records of 2123 consecutive HIV-infected patients hospitalized in a 9-year period were retrospectively reviewed, and 4 cases of community-acquired M. catarrhalis pneumonia were identified. Three adult patients had a diagnosis of AIDS and severe concurrent immunodeficiency (with a CD4+ lymphocyte count below 60 cells/microL), while the fourth case involved a child with vertical HIV disease. Leukopenia and neutropenia were never present, but no patient received a potent antiretroviral regimen at the time of disease onset. A concurrent respiratory infection by Streptococcus pneumoniae and Mycobacterium tuberculosis was recognized in 2 of 4 patients. Isolated M. catarrhalis strains were susceptible to all tested antimicrobial compounds (save ampicillin in 2 cases), and appropriate antimicrobial treatment led to clinical and microbiological cure in all described episodes. Only 8 cases of HIV-associated Moraxella spp. disease have been reported to date in seven different literature reports (6 cases of pneumonia, and 1 of septicemia). According to our experience, M. catarrhalis may be responsible for appreciable morbidity among patients with advanced HIV infection, especially when a low CD4+ cell count or coexisting respiratory disease are present. Clinicians and microbiologists who care for HIV-infected patients should carefully consider the potential pathogenic role of Moraxella spp. organisms.
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PMID:Moraxella catarrhalis pneumonia during HIV disease. 1112 60

Although resistance to Listeria monocytogenes infection requires intact T-cell mediated immunity, listeriosis is an infrequent problem in patients with HIV infection and only about 50 patients have been reported to date. Only two patients with HIV and L. monocytogenes have been attended in our hospital since the beginning of aids epidemic in 1981. Case 1: a man with HIV and 364 CD4+ cells/mm3 presented fever and occipital headache. The cerebral scan was normal and L. monocytogenes grew in licuor culture. He was outcome after treatment with ampicillin and tobramycin. Case 2: a 47 years old man with HIV, 44 CD4+ cells/mm3 and hepatic virus C cirrhosis was admitted to the hospital because fever and abdominal distension. He was on menstrual pentamidine prophylaxis for Pneumocystis carinii pneumonia (PCP). Bacterial peritonitis was diagnosed and the patient begun treatment with ceftriaxone. The patient dead 72 hours later with hepatic encepholopathy. Postmortem L. monocytogenes grew. Listeriosis is an infrequent disease in patients with HIV that causes difficult diagnostic problems, principally in patients without prophylaxis with cotrimoxazole for PCP.
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PMID:[Listeriosis: an infrequent infection in patients with HIV]. 1121 81

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.
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PMID:Enterobacter spp. infections complicating the course of HIV disease. 1133 Mar 68

A hospital-based prospective study of 99 patients with community-acquired pneumonia (CAP) was carried out in Kampala, Uganda. We evaluated microbiological etiologies, clinical features and effectiveness of short-term parenteral ampicillin followed by oral amoxicillin for these patients in relation to HIV-status. We demonstrated a very high prevalence (75%) of HIV-1 infection. No significant difference was observed with respect to age, gender, prior antibiotic usage, symptoms, laboratory data or bacterial etiology between HIV-1-infected and HIV-uninfected CAP patients. Most strains of Streptococcus pneumoniae (n = 19) and Haemophilus influenzae (n = 8) isolated from HIV-1-infected patients were penicillin-resistant (95%) and beta-lactamase producing (75%) strains, respectively. A high percentage of good clinical response was found in both HIV-1-infected (81%) and HIV-uninfected (86%) among 39 patients with CAP due to a defined bacterial pathogen. These data support the use of short-term parenteral ampicillin for patients with bacterial CAP irrespective of HIV-status.
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PMID:Community-acquired pneumonia in Ugandan adults: short-term parenteral ampicillin therapy for bacterial pneumonia. 1144 14

To evaluate the WHO (World Health Organization) algorithm for management of respiratory tract infection (RTI) in HIV-1-infected adults and determine risk factors associated with RTI, we enrolled a cohort of 380 HIV-1-seropositive adults prospectively followed for incident RTI at an outpatient clinic in Nairobi, Kenya. RTI was diagnosed when patients presented with history of worsening or persistent cough. Patients were treated with ampicillin, or antituberculosis therapy when clinically indicated, as first-line therapy and with trimethoprim/sulfamethoxazole as second-line therapy. Five hundred ninety-seven episodes of RTI were diagnosed: 177 of pneumonia and 420 of bronchitis. The WHO RTI algorithm was used for 401 (95%) episodes of bronchitis and 151 (85%) episodes of pneumonia (p <.001). Three percent of bronchitis cases versus 32% of pneumonia cases failed to respond to first-or second-line treatment (p <.0001). Being widowed (adjusted odds ratio [OR] = 2.1, 95% confidence interval [CI]: 1.0-4.4), less than 8 years of education (adjusted OR = 2.5, CI: 1.5 - 4.1), and CD4 count < 200 cells/microl (adjusted OR = 2.4, CI: 1.4-3.9) were risk factors for pneumonia. A high percentage of patients (32%) with pneumonia required a change in treatment from that recommended by the WHO guidelines. Randomized trials should be performed to determine more appropriate treatment strategies in HIV-1-infected individuals.
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PMID:Respiratory tract infection in HIV-1-infected adults in Nairobi, Kenya: evaluation of risk factors and the world health organization treatment algorithm. 1146 24

Our knowledge of chronic suppurative otitis media is scanty in Ethiopia. This hospital-based study was, thus, conducted prospectively over a period of 2 years among children visiting a tertiary facility in Addis Ababa. Demographic, clinical, audiometric and microbiological data were collected using a preformed questionnaire. A total of 391 patients constituting 0.6% of the hospital patient population and 22.3% of those seen at the ear, nose, and throat clinic had chronic suppurative otitis media. Most (82.1%) of them were from Addis Ababa, the male to female ratio was 1.6:1, and their median age at presentation was 5.9 years. Otorrhoea had started before the age of 2 years in 269 (68.8%), was bilateral in 215 (55.0%), recurrent in 285 (72.9%), and continuous in 106 (27.1%). Otalgia was reported in only 18%. Hearing loss was the major presenting symptom and the loss was moderate to severe (grades 2 and 3) in 32 (69.6%) and slight (grade 1) in 14 (30.4%) of the ears tested audiometrically. Malnutrition, nasopharyngitis, measles, HIV infection, tuberculosis, diabetes mellitus, neoplastic diseases, and structural abnormalities were common antecedents. Serious complications included systemic infections, otogenic meningitis, mastoiditis, and tetanus. A total of 106 bacterial isolates were cultured from ear discharges of 80 patients. Proteus species were the commonest, accounting for 40 (37.7%) followed by Staphylococcus aureus, Pseudomonas aeruginosa, and Gram negative enterics. All isolates were highly resistant to the commonly used antibiotics including penicillin, ampicillin, amoxycillin, trimethoprim-sulfamethoxazole, and chloramphenicol. Augmentin, gentamicin, and kanamycin were the only drugs to which most of the pathogens were sensitive. Marked improvement on the discharge was achieved in 64% of the 116 patients who complied with treatment. Awareness about the health implications of the disease seemed to be lacking in among the caretakers. Selective use of antibiotics and continuous aural cleansing need to be promoted. More elaborate epidemiological studies will be required to define the magnitude of the problem and identify optimal therapeutic modalities of suppurative ear disease in Ethiopia.
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PMID:Chronic suppurative otitis media in a children's hospital in Addis Ababa, Ethiopia. 1196 74

In order to assess the clinical role of bacterial complications due to Acinetobacter spp. during HIV disease, a retrospective survey of clinical and microbiological data of 2221 HIV-infected patients hospitalised during the past 10 years was carried out, evaluating all episodes of Acinetobacter spp. infection according to several epidemiological, clinical and therapeutic variables. Eleven patients of 2221 (0.5%) suffered from Acinetobacter spp. disease: sepsis in 5 cases, and urinary, respiratory tract disease and bacteremic pneumonia in three, two, and one patient respectively. A. calcoaceticus was responsible in 4 cases, A. lwoffii in three, and Acinetobacter spp. in the 4 remaining cases; 4 patients experienced a polymicrobial infection, and 7 had a prior diagnosis of full-blown AIDS. All patients had a severe HIV-related immunodeficiency (mean CD4+ lymphocyte count 118.2 +/- 45.3 cells/microl). Compared with other localizations, sepsis was related to a lower mean CD4+ cell count (p<.001), and a more frequent occurrence of leucopenia-neutropenia (p<.005). Disease episodes diagnosed after the first 72 hours of hospitalisation (deemed no- socomial in origin), proved more frequent than community-acquired ones (9 cases versus 2), affected predominantly patients with AIDS and neutropenia, and were frequent1y associated with bacteremia (p<.04) The use of broad spectrum antibiotics, corticosteroids and cotrimoxazole, was recognized during the month preceding the diagnosis of Acinetobacter spp. disease, in 6, 4, and 8 cases, respectively. One patient only had an indwelling intravascular catheter, while no recent history of surgery, intensive care, or other invasive procedures was found. At in vitro susceptibility studies, bacterial isolates showed complete resistance to ampicillin and cephalothin, and low sensitivity to second-generation cephalosporins, while a higher susceptibility rate was revealed towards ceftazidime, netilmicin, amikacin, and quinolones, followed by cotrimoxazole and piperacillin. A prompt and appropriate antimicrobial therapy (mostly carried out with cephalosporins and aminoglycosides), led all patients to a clinical and microbiological cure within 6-1.3 days, in the absence of mortality or relapses. As opportunist pathogens with a predominant nosocomial origin, Acinetobacter spp. organisms may be responsible for an appreciable morbidity in patients with HIV disease, especially when additional risk factors (immunodeficiency, underlying diseases, and hospitalisation) are present. Notwithstanding the high drug resistance profile of the majority of isolated organisms, a timely diagnosis and a treatment based on in vitro assays, contribute to avoid recurrences and potentially life-threatening complications.
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PMID:[Pathogenic role of Acinetobacter spp during HIV infection]. 1208 49

Potential enteric bacterial pathogens in 60 HIV-positive patients with chronic diarrhoea in rural communities of the Limpopo Province, South Africa, were identified using standard microbiological methods. The Kirby-Bauer disk-diffusion method was employed to determine antibiograms of isolated bacteria. Results revealed that diarrhoeagenic bacterial agents were isolated from 48 (80%) of the 60 HIV-positive patients with diarrhoea. Forty-four (73.3%) and 16 (26.7%) of the 60 patients were female and male respectively in the age range of 17-55 years with a mean of 34 years. Bacterial pathogens isolated comprised Campylobacter species (20.0%), Plesiomonas shigelloides (16.6%), Aeromonas species (13.3%), and Escherichia coli, Shigella and Salmonella species (10.0% each). No attempts were made to isolate parasites, fungi, or viruses. Antibiotic susceptibility profiles revealed resistance of the isolates to ampicillin, cephalothin, chloramphenicol, erythromycin, and streptomycin. However, all (100%) of P. shigelloides and Salmonella species were sensitive to nalidixic acid and ciprofloxacin. Most isolates were susceptible to nalidixic acid, ciprofloxacin, and gentamicin, indicating the usefulness of these drugs, although antibiograms may not always correlate with clinical usefulness.
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PMID:Diarrhoeagenic bacterial pathogens in HIV-positive patients with diarrhoea in rural communities of Limpopo Province, South Africa. 1243 Jul 59

Acute respiratory infections (ARI) are still a major health problem in most developing countries. So far no study has evaluated the importance of childhood ARI in rural Senegal. We prospectively studied ARI, the percentage of pneumonia and related mortality, as well as the bacterial composition of nasopharyngeal flora using nasopharyngeal aspirates in 114 children, aged 2-59 months, presenting at Ndioum's pediatric ward. Excluded from the trial were those children that had had antimicrobial therapy in the previous 2 weeks. The Kirby-Bauer method was used to determine antibiotic resistance throughout the study. The percentage of ARI and pneumonia among the population tested was 24 per cent and 11 per cent respectively. Streptococcus pneumonia was often resistant to cotrimoxazole (31 per cent) but only 9 per cent were resistant to chloramphenicol and 14 per cent to penicillin. Haemophilus influenzae (HI) was uniformly sensitive to ampicillin, and only 4 per cent were resistant to chloramphenicol and 11 per cent to cotrimoxazole. We conclude that SP and HI resistance to cotrimoxazole is important and warrants larger clinical trials using chloramphenicol. Information campaigns and intense management of comorbidities are desirable in this type of population. Comorbidities (tuberculosis, malaria, HIV-AIDS, severe malnutrition) are determinant variables in many ARI cases and carry a high negative prognosis value.
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PMID:Percentage, bacterial etiology and antibiotic susceptibility of acute respiratory infection and pneumonia among children in rural Senegal. 1263 Jul 17


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