Bloodstream infections among HIV-infected outpatients, Southeast Asia

  • Varma J
  • McCarthy K
  • Tasaneeyapan T
 et al. 
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Abstract

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.

Author-supplied keywords

  • AIDS-Related Opportunistic Infections/*epidemiolog
  • Adult
  • Asia, Southeastern/epidemiology
  • Bacteremia/*epidemiology/microbiology
  • Bacteria/classification/isolation & purification
  • Cambodia/epidemiology
  • Female
  • Fungemia/*complications/*epidemiology/microbiology
  • Fungi/classification/isolation & purification
  • HIV Infections/*complications/epidemiology/virolog
  • Humans
  • Male
  • Mycobacterium tuberculosis/isolation & purificatio
  • Outpatients
  • Prevalence
  • Risk Factors
  • Thailand/epidemiology
  • Tuberculosis/epidemiology/microbiology
  • Vietnam/epidemiology

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Authors

  • J K Varma

  • K D McCarthy

  • T Tasaneeyapan

  • P Monkongdee

  • M E Kimerling

  • E Buntheoun

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