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