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Gram-negative septicemia seems to be related to CMV infection in HIV patients with CD4 < 100/mmc.




 

Int Conf AIDS. 1993 Jun 6-11;9(1):321 (abstract no. PO-B06-1112). Unique

AIM OF THE STUDY: To verify the prevalence of bacterial agents found in septicemic episodes of HIV+ patients in order to find possible correlations between agents and the clinical course of the disease. METHODS: Sixty-two septicemic episodes in 51 HIV + patients between 1986 and 1992 were retrospectively analyzed. Demographic features, risk factors, clinical and laboratory stage, PCP prophylaxis and underlying major opportunistic infections were statistically compared to bacterial isolates, nosocomial onset, focus of infection, presence of intravenous devices, fever and outcome. RESULTS: A gram-negative septicemia GNS) was found in 37.1% of all bacteremic episodes and shown to be associated with lower CD4 count (44.4/mmc; p < 0.05), abdominal symptoms (p < 0.05) and more rapid fever defervescence 2.4 +/- 1.5 days; p < 0.05). Enterobacteriaceae (including Non-typhi Salmonellae and E.coli) were the most common organisms involved. Furthermore, in patients with CD4 cells < 100/mmc, GNS was significantly associated to an active or incipient CMV infection (p = 0.02) clinically or autoptically documented. CONCLUSIONS: Both epidemiological and clinical classical features of gram-negative septicemias were confirmed in our study where a surprising association between GNS and active CMV infection in severely immunocompromised patients was also observed. A possible role of CMV intestinal lesions in the mechanism of blood stream invasion by gram-negative bacteria may be suggested.

*Cytomegalovirus Infections/EPIDEMIOLOGY *CD4-Positive T-Lymphocytes *Gram-Negative Bacterial Infections/EPIDEMIOLOGY *HIV Infections/EPIDEMIOLOGY *Septicemia/EPIDEMIOLOGY



 




Information in this article was accurate in November 30, 1993. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.