title: Management of severe non-TB bacterial infection in HIV-infected adults.
abstract: Despite widespread antiretroviral therapy use, severe bacterial infections (SBI) in HIV-infected adults continue to cause significant morbidity and mortality globally. Four main pathogens account for the majority of documented SBI: Streptococcus pneumoniae, non-typhoidal strains of Salmonella enterica, Escherichia coli and Staphylococcus aureus. The epidemiology of SBI is dynamic, both in developing countries where, despite dramatic successes in antiretroviral therapy, coverage is far from complete, and in settings in both resource-poor and resource-rich countries where antiretroviral therapy failure is becoming increasingly common. Throughout the world, this complexity is further compounded by rapidly emerging antimicrobial resistance, making management of SBI very challenging in these vulnerable patients. We review the causes and treatment of SBI in HIV-infected people and discuss future developments in this field.
authors.affiliation: Malawi Liverpool Wellcome Trust Clinical Research Programme, University of Malawi College of Medicine, Blantyre, Malawi.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Gaskell
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Feasey
authors.forename: Robert S
authors.initials: RS
authors.lastname: Heyderman
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000628:therapy*; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000150:complications / Q000628:therapy*; D003906:Developing Countries; D019468:Disease Management; D024881:Drug Resistance, Bacterial; D015658:HIV Infections / Q000150:complications / Q000628:therapy*; D006295:Health Resources; D006801:Humans
chemical_list: D000890:Anti-Infective Agents; D000998:Antiviral Agents
keywords: HIV; antimicrobial resistance; bloodstream infections; pneumonia; severe bacterial infection