Bloodstream infections among HIV-infected outpatients, Southeast Asia.
Bloodstream infections (BSIs) are a major cause of illness in HIV-infected persons. To evaluate prevalence of and risk factors for BSIs in 2,009 HIV-infected outpatients in Cambodia, Thailand, and Vietnam, we performed a single Myco/F Lytic blood culture. Fifty-eight (2.9%) had a clinically significant BSI (i.e., a blood culture positive for an organism known to be a pathogen). Mycobacterium tuberculosis accounted for 31 (54%) of all BSIs, followed by fungi (13 [22%]) and bacteria (9 [16%]). Of patients for whom data were recorded about antiretroviral therapy, 0 of 119 who had received antiretroviral therapy for ≥14 days had a BSI, compared with 3% of 1,801 patients who had not. In multivariate analysis, factors consistently associated with BSI were fever, low CD4+ T-lymphocyte count, abnormalities on chest radiograph, and signs or symptoms of abdominal illness. For HIV-infected outpatients with these risk factors, clinicians should place their highest priority on diagnosing tuberculosis.
Varma
Jay K
JK
Thailand Ministry of Public Health-US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand. jvarma@cdc.gov
McCarthy
Kimberly D
KD
Tasaneeyapan
Theerawit
T
Monkongdee
Patama
P
Kimerling
Michael E
ME
Buntheoun
Eng
E
Sculier
Delphine
D
Keo
Chantary
C
Phanuphak
Praphan
P
Teeratakulpisarn
Nipat
N
Udomsantisuk
Nibondh
N
Dung
Nguyen H
NH
Lan
Nguyen T N
NT
Yen
Nguyen T B
NT
Cain
Kevin P
KP
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000382:microbiology; D000328:Adult; D001210:Asia, Southeastern / Q000453:epidemiology; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D002160:Cambodia / Q000453:epidemiology; D005260:Female; D016469:Fungemia / Q000150:complications* / Q000453:epidemiology* / Q000382:microbiology; D005658:Fungi / Q000145:classification / Q000302:isolation & purification; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D010045:Outpatients; D015995:Prevalence; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology / Q000382:microbiology; D014744:Vietnam / Q000453:epidemiology