[Pneumonia caused by non-opportunistic bacteria in patients infected with HIV. Incidence and evaluation of a non-invasive approach].
BACKGROUND
Pneumonia due to pathogenic bacteria is common in HIV infected patients. However, a global overview has not been yet performed and also the effectiveness of a non-invasive approach has not been tested.


METHODS
An open study was conducted in 1989 including all HIV infected patients with a presumptive or definite diagnosis of bacterial pneumonia. Fiberoptic bronchoscopy procedures were used only in patients with a difficult diagnosis and/or problems in their clinical evolution. Clinical and biological data were compared among different etiologic groups, and their evolution was also recorded in relation with the use of non-invasive procedures.


RESULTS
Among a total of 302 admissions of HIV infected patients, 113 developed a primary or secondary respiratory tract infection. Forty-three of those were bacterial pneumonia episodes. Etiologic diagnosis was achieved with non invasive methods in 18 cases (42%). Blood cultures were the most effective method used. Streptococcus pneumoniae was the most frequently identified microorganisms (9 cases, 21%). The identification of other bacteria was linked with more severe forms of disease regarding immunologic (leukopenia, p less than 0.001; T4 lymphopenia, p less than 0.05), and respiratory parameters (hypoxemia, p less than 0.05). Two deaths were directly related with pneumonia of known etiology.


CONCLUSIONS
Bacterial pneumonia is the most frequent respiratory infection in HIV infected patients. An initial non-invasive approach yields a reasonable percentage of etiologic diagnosis and is not related with a poorer outcome.
Teira
R
R
Sección de Enfermedades Infecciosas, Hospital Civil de Bilbao.
Zubero
Z
Z
Muñoz
J
J
Alvarez
M
M
Cisterna
R
R
Santamaría
J M
JM
D001424:Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D001999:Bronchoscopy; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D008297:Male; D011014:Pneumonia / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D015995:Prevalence; D012141:Respiratory Tract Infections / Q000150:complications / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology
Neumonía por bacterias no oportunistas en pacientes infectados por VIH. Incidencia y valoración de una aproximación no invasiva.