Epidemiological studies on pulmonary pathogens in HIV-positive and -negative subjects with or without community-acquired pneumonia with special emphasis on Mycoplasma pneumoniae.
The prevalence of Mycoplasma pneumoniae among HIV-positive patients with community-acquired pneumonia (CAP) remains unclear. We investigated 300 HIV-positive adults (200 with CAP and 100 with no respiratory illness) and 75 HIV-negative adults with CAP for the prevalence of respiratory pathogens using culture and serology. A growth inhibition test was employed to confirm the isolates of M. pneumoniae using species-specific typing sera. The prevalence of M. pneumoniae in HIV-positive subjects was 17% by induced sputum and 11.3% by throat swab culture. The seroprevalence of anti-M. pneumoniae IgM was 11.7% by ELISA and 14.3% by the gelatin microparticle agglutination test. The prevalence of M. pneumoniae among HIV-negative cases was relatively low. Streptococcus pneumoniae was predominant (28%) among subjects with lower respiratory disease, whereas Staphylococcus aureus (15%) was common among upper respiratory symptomatic cases. Rales (P=0.001), pharyngeal erythema (P=0.02), cervical adenopathy (P=0.004), skin rash (P=0.001), and crepitations (P=0.001) were each significantly related to M. pneumoniae positivity. Statistical significance was observed in relation to total lymphocyte count (P=0.02) and erythrocyte sedimentation rate (P=0.04), as well as M. pneumoniae positivity. This study shows that the prevalence of M. pneumoniae in HIV-positive subjects is comparatively higher than in HIV-negative subjects with pulmonary symptoms, and concords with previous pilot studies carried out in Chennai, South India.
Shankar
Esaki Muthu
EM
Department of Microbiology, Faculty of Medicine, Dr. ALM PG IBMS, University of Madras, Chennai, India.
Kumarasamy
Nagalingeswaran
N
Vignesh
Ramachandran
R
Balakrishnan
Pachamuthu
P
Solomon
Sunil Suhas
SS
Murugavel
Kailapuri Gangatharan
KG
Saravanan
Shanmugam
S
Velu
Vijayakumar
V
Farooq
Shukkur Muhammed
SM
Hayath
Kownhar
K
Muthu
Sundaram
S
Solomon
Suniti
S
Rao
Usha Anand
UA
D000328:Adult; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007194:India / Q000453:epidemiology; D008168:Lung / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification*; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D011019:Pneumonia, Mycoplasma / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D011446:Prospective Studies