title: Campylobacter infections in HIV-infected patients: clinical and bacteriological features.
abstract: OBJECTIVE
  To study the clinical and bacteriological features of Campylobacter infections in HIV-infected patients.
  
  
  METHODS
  A retrospective analysis (1989-1992), followed by a prospective analysis (1992-1994).
  
  
  METHODS
  Hospital HIV inpatient unit.
  
  
  METHODS
  All patients with Campylobacter spp. identified by the laboratory of microbiology at Saint-Louis Hospital, Paris were studied, and their clinical features as well as their response to therapy recorded.
  
  
  RESULTS
  During the study period, Campylobacter infection was documented in 38 HIV-infected patients, 76% of whom had AIDS. Campylobacter spp. was isolated from stools in 36 cases and from blood cultures in four cases. Species identification yielded C. jejuni (84%) and C. coli (16%). High-level resistance to quinolones was frequently observed (21%), but resistance to erythromycin (3%) and tetracycline (5%) was rare. Diarrhoea, fever and abdominal pain were the main clinical features of infection. Other intestinal pathogens were found in 42% of patients. Most patients had an acute illness with rapid resolution under appropriate antimicrobial therapy. However, eight patients (21%), experienced chronic diarrhoea with persistent isolation of Campylobacter and in vivo selection of resistant strains, requiring multiple courses of antibiotics.
  
  
  CONCLUSIONS
  Campylobacter usually cause acute diarrhoea in patients with HIV infection. Antimicrobial therapy should be guided on in vitro susceptibility testing because of the prevalence of antibiotic resistance. Despite appropriate therapy, some patients will present with prolonged diarrhoea and in vivo selection of multiresistant isolates.
authors.affiliation: Infectious Disease Department, Saint-Louis Hospital, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Molina
authors.forename: I
authors.initials: I
authors.lastname: Casin
authors.forename: P
authors.initials: P
authors.lastname: Hausfater
authors.forename: E
authors.initials: E
authors.lastname: Giretti
authors.forename: Y
authors.initials: Y
authors.lastname: Welker
authors.forename: J
authors.initials: J
authors.lastname: Decazes
authors.forename: V
authors.initials: V
authors.lastname: Garrait
authors.forename: P
authors.initials: P
authors.lastname: Lagrange
authors.forename: J
authors.initials: J
authors.lastname: Modaï
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017000:Campylobacter coli / Q000187:drug effects / Q000302:isolation & purification; D016123:Campylobacter jejuni / Q000187:drug effects / Q000302:isolation & purification; D003967:Diarrhea / Q000150:complications / Q000188:drug therapy / Q000382:microbiology; D004352:Drug Resistance, Microbial; D005243:Feces / Q000821:virology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents