Campylobacter infections in HIV-infected patients: clinical and bacteriological features.
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.
Molina
J
J
Infectious Disease Department, Saint-Louis Hospital, Paris, France.
Casin
I
I
Hausfater
P
P
Giretti
E
E
Welker
Y
Y
Decazes
J
J
Garrait
V
V
Lagrange
P
P
Modaï
J
J
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
D000900:Anti-Bacterial Agents