International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
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Int. J. Infect. Dis. · Mar 2002
Changes in bloodstream infections in HIV-positive patients in a university hospital in Spain (1995-1997).
The Hospital Universitario Germans Trias i Pujol is a 600-bed center serving 700,000 inhabitants including 1800 patients with HIV infection in Catalonia (Spain). Highly active antiretroviral therapy (HAART) became available at the end of 1996. Thus, the period 1995 1997 was considered appropriate for evaluating possible epidemiological changes in bloodstream infections (BSI) in HIV-infected patients. ⋯ The prevalence of bloodstream infections in HIV-positive patients has decreased since the introduction of HAART and the immunologic state has improved. Furthermore there is a trend to a decrease or disappearance of microorganisms, such as Pseudomonas spp., Mycobacterium tuberculosis, MAI or fungi related to severe immunosuppression. Lastly, bacteremia caused by the active use of intravenous drugs remains stable with the highest percentage in Spain.
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To determine the potential role of steroid therapy combined with early antiviral and supportive care in patients infected with human immunodeficiency virus (HIV) with varicella pneumonia. ⋯ Hospitalized patients with HIV or AIDS with chickenpox are at high risk for developing varicella pneumonia. There is a potentially high rate of death despite prompt initiation of appropriate antiviral therapy. Intensive care management and adjunctive use of systemic corticosteroids may improve outcome.
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Int. J. Infect. Dis. · Jan 2001
Tuberculosis and drug resistance among patients seen at an AIDS Reference Center in São Paulo, Brazil.
To assess the frequency of resistance of Mycobacterium tuberculosis to antituberculosis drugs and the factors associated with it among patients with tuberculosis (TB) and acquired immunodeficiency syndrome (AIDS). ⋯ In this patient series, M. tuberculosis resistance was predominantly of the acquired type, and resistance was independently associated with previous treatment for TB and with duration of AIDS prior to TB exceeding 71 days.
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Int. J. Infect. Dis. · Jan 2000
Ceftazidime-resistant Klebsiella pneumoniae bloodstream infection in children with febrile neutropenia.
To evaluate prevalence of ceftazidime-resistant Klebsiella pneumoniae (CRKP) in the pediatric oncology unit of University Hospital, Kuala, Lumpur, and to identify differences between febrile neutropenic pediatric patients with CRKP and ceftazidime-sensitive K. pneumoniae (CSKP) bacteremia. ⋯ More than half of total K. pneumoniae isolated from blood cultures in the unit were ceftazidime-resistant. Children with febrile neutropenia with prolonged hospital stay and recent prior antibiotic exposure are at high risk of developing CRKP bacteremia. Mortality was significantly higher in this group. Early commencement of appropriate antibiotics (e.g., imipenem with or without gentamicin), according to susceptibility study results, may be beneficial in such circumstances.