title: Epidemiological studies on pulmonary pathogens in HIV-positive and -negative subjects with or without community-acquired pneumonia with special emphasis on Mycoplasma pneumoniae.
abstract: 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.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Dr. ALM PG IBMS, University of Madras, Chennai, India.
authors.forename: Esaki Muthu
authors.initials: EM
authors.lastname: Shankar
authors.forename: Nagalingeswaran
authors.initials: N
authors.lastname: Kumarasamy
authors.forename: Ramachandran
authors.initials: R
authors.lastname: Vignesh
authors.forename: Pachamuthu
authors.initials: P
authors.lastname: Balakrishnan
authors.forename: Sunil Suhas
authors.initials: SS
authors.lastname: Solomon
authors.forename: Kailapuri Gangatharan
authors.initials: KG
authors.lastname: Murugavel
authors.forename: Shanmugam
authors.initials: S
authors.lastname: Saravanan
authors.forename: Vijayakumar
authors.initials: V
authors.lastname: Velu
authors.forename: Shukkur Muhammed
authors.initials: SM
authors.lastname: Farooq
authors.forename: Kownhar
authors.initials: K
authors.lastname: Hayath
authors.forename: Sundaram
authors.initials: S
authors.lastname: Muthu
authors.forename: Suniti
authors.initials: S
authors.lastname: Solomon
authors.forename: Usha Anand
authors.initials: UA
authors.lastname: Rao
mesh_terms: 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