Ortega GLM, Marrero MO, Valdés CJ, Baly GA, Verdasquera CD

Language: Spanish
References: 33
Page: 1-17
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ABSTRACT

Introduction: Bacterial diseases are one of the most important causes of morbidity and mortality in patients infected with human immunodeficiency virus (HIV). To this event are added nowadays infections associated with health services, a scenario aggravated by the emergence of bacteria with multi-resistance, which negatively impact human health.
Objective: Characterize bacterial infections in Cuban HIV patients, admitted to the hospital center of "Pedro Kourí" Institute of Tropical Medicine between January 2014 and December 2017.
Methods: A cross-sectional study with analytical component was conducted consisting of 538 HIV-1 positive patients diagnosed with bacterial infection detected by microbiological isolation.
Results: Bacterial infections at the airway level in patients with HIV and CD4≤ 200cel/mm3 were the most common events. The highest positivity was demonstrated in samples of blood culture and bacteriological sputus with 40.1% and 36.1%, respectively. 69.7% of isolations showed healthcare-associated infection revealing statistically significant association with selected risk factors (prolonged hospital stays and devices use), as well as infection with gram-negative bacteria and coagulase-positive staph.
Conclusions: Bacterial infections are common in HIV patients with severe immunosuppression and pneumonia is its main cause. There is a high incidence of healthcare-associated infection, which shows statistically significant association with prolonged hospital stays and devices use, also reveal association with isolations of gram-negative bacteria and coagulase-positive staph.

REFERENCES

1. García Castellanos T, Martínez Mota I, Salazar Rodríguez D, Pérez Monrás M, Pérez Ávila J. Identificación y sensibilidad antimicrobiana de bacterias Gram negativas causantes de neumonía en pacientes VIH/sida. Rev Cub de Plantas Medicinales. 2012;31(1):53-62.]

2. Salami AK, Olatunji PO, Oluboyo PO, Akanbi AA, Fawibe EA. Bacterial pneumonia in the AIDS patients. West Afr J Med. 2006;25(1):1-5.]

3. Sued O, Ben G, Pérez H. Cuidados intensivos en pacientes con infección por VIH. Rev Patología Urgencia. 2012;10:9-18.]

4. French M, Keane N, McKinnon E, Phung S, Price P. Susceptibility to opportunistic infections in HIV-infected patients with increased CD4 T-cell counts on antiretroviral therapy may be predicted by markers of dysfunctional effect or memory CD4 T-cells and B cells. HIV Med. 2007;8(3):148-55.]

5. García Castellanos T, Verdasquera Corcho D, Pérez Ávila J, Martínez Mota I, Salazar Rodríguez D, Pérez Monrás M. Neumonía bacteriana en pacientes VIH/Sida. Rev Cubana Investig Bioméd. 2010 [acceso 02/12/2019];29(4):428-36. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-03002010000400003&lng=es]

6. Sogaard OS, Lohse N, Gerstoft J, Kronborg G, Ostergaard L, Pedersen C, et al. Hospitalization for pneumonia among individuals with and without HIV infection, 1995-2007: A Danish Population-Based, Nationwide Cohort Study. Clin Infect Dis. 2008;47(10):1345-53. DOI: 10.1086/592692]

7. Le Moing V, Rabaud C, Journot V, Duval X, Cuzin L. Incidence and risk factors of bacterial pneumonia requiring hospitalization in HIV-infected patients started on a protease inhibitor-containing regime. HIV Med. 2006;7(4):261-7]

8. Vento Valdés I, Toraño Peraza G, Del Sol González AC, Piquero Lazo EM. Bacteriemia relacionada con catéter por Staphylococcus aureus resistente a meticilina en pacientes con enfermedad renal crónica avanzada. Rev Cub de Med Tropical. 2019 [acceso 12/03/2020];71(2):e427. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0375-07602019000200007&lng=es]

9. Báez Y, Lugo FE, Rodríguez N, Báez JM, Alfonso RA. Aspectos clínicos relacionados con los catéteres centrovenosos temporales y permanentes para hemodiálisis. Revista Cubana de Medicina Militar. 2011 [acceso 14/01/2020];40(2):104-13. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572011000200002&lng=es]

10. Sievert DM, Ricks P, Edwards JR, Schneider A, Patel J, Srinivasan A, et al. Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the national healthcare safety network atthe centers for disease control and prevention, 2009-2010. Infect Control Hosp Epidemiol. 2013;34:1-1. DOI: 10.1086/668770]

11. Sante L, Aguirre-Jaime A, Miguel MA, Ramos MJ, Pedroso Y, Lecuona M. Epidemiological study of secondary bloodstream infections: The forgotten issue. J Infect Public Health. 2018;12(1):37-42. DOI: 10.1016/j.jiph.2018.08.011]

12. Sante L, Lecuona M, Aguirre Jaime A, Arias A. Factores de riesgo en bacteriemias nosocomiales secundarias a ITU en un hospital terciario. Rev Esp Quimioter 2019 [acceso 21/12/2018];32(4):311-16. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6719644/]

13. Delgado-Capel M, Gabillo A, Elias L, Yébenes JC, Sauca G, Anton Capdevila J. Características de la bacteriemia relacionada con catéter venoso periférico en un hospital general. Rev Esp Quimioter 2012;25(2):129-33.]

14. Kallen AJ, Patel PR, O'Grady NP. Preventing catheter-related bloodstream infections outside the intensive care unit: expanding prevention to new settings. Clin Infect Dis. 2010;51:335- 41.]

15. Panis C, Matsuo T, Reiche EM. Nosocomial infections in human immunodeficiency virus type 1 (HIV-1) infected and AIDS patients: major microorganisms and immunological profile. Brazilian Journal of Microbiology. 2009;40(1):155-162. DOI:10.1590/S1517-838220090001000027]

16. Uwe F, Franz D, Gabi S, Mills J. Incidence and Epidemiology of Nosocomial Infections in Patients Infected with Human Immunodeficiency Virus. Clinical Infectious Diseases. 2011;25:318-20.]

17. Dos Reis D, Do Rosário Souza IC, de Oliveira Neves DC, Rodrigues Marsola L, Medeiros Sousa RC. Healthcare-associated infections among HIV-positive and HIV/AIDS-negative patients: a casuistic from the Amazonian Region. Rev Pan-Amaz Saude. 2013;4(2):27-32. DOI: 10.5123/S2176-62232013000200004]

18. Danasekaran GM, Annadurai K. Prevention of health care associated infections: protecting patients, saving lives. Int J Community Med Public Health. 2014;1(1):67-8.]

19. Melzer M, Welch C. Does the presence of a urinary catheter predict severe sepsis in a bacteraemic cohort? J Hosp Infect. 2017;95(4):376-382. DOI: 10.1016/j.jhin.2017.01.003]

20. World Health Organization. Core components for infection prevention and control programmes. Report of the second meeting of the Informal Network on Infection Prevention and Control in Healthcare. Ginebra: WHO; 2015.]

21. Villabos AP, Barrero LI, Rivera SM, Ovalle MV, Valera DA. Vigilancia de infecciones asociadas a la atención en salud, resistencia bacteriana y consumo de antibióticos en hospitales de alta complejidad, Colombia, 2011. Biomédica 2014;34(Supl.1):67-80.]

22. Rosenthal VD, Maki DG, Salomao R, Moreno CA, Mehta Y, Higuera F, et al. Device-associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann Intern Med. 2006;145(8):582-91. DOI: 10.7326/0003-4819-145-8-200610170-00007]

23. Chenoweth CE, Saint S. Urinary tract infection. Infect Dis Clinic N Amer. 2011;25(1):103-115. DOI: 10.1016/j.idc.2010.11.005]

24. Centers for Diseases Control and Prevention. CDC/NHSN Surveillance Definitions for Specific Types of Infections. EE. UU.: NHSN: CDC; 2018. [acceso 21/12/2018]. Disponible en: Disponible en: https://www.cdc.gov/nhsn/pdfs/pscmanual/17pscnosinfdef_current.pdf]

25. Magill SS, Wilson LE, Thompson DL, Ray SM, Nadle J, Lynfield R, et al. Emerging Infections Program Hospital Prevalence Survey Team. Reduction in the Prevalence of Healthcare-Associated Infections in US. Acute Care Hospitals, 2015 vs 2011. Open Forum Infect Dis. 2017;4(Suppl 1):S49. DOI: 10.1093/ofid/ofx162.116]

26. Kritsotakis EI, Kontopidou F, Astrinaki E, Roumbelaki M, Ioan-nidou E, Gikas A. Prevalence, incidence burden, and clinical impact of healthcare-associated infections and antimicrobial resistance: a national prevalent cohort study in acute care hospitals in Greece. Infect Drug Resist. 2017;10:317-328. DOI: 10.2147/IDR.S147459]

27. Ling ML, Apisarnthanarak A, Madriaga G. The Burden of Healthcare-Associated Infections in Southeast Asia: A Systematic Literature Review and Meta-analysis. Clin Infect Dis. 2015;60(11):1690-99. DOI: 10.1093/cid/civ095]

28. Alvarez-Lerma F, Palomar M, Olaechea P, Otal JJ, Insausti J, Cerda E. National Study of Control of Nosocomial Infection in Intensive Care Units.Evolutive report of the years 2003-2005. Med Intensiva. 2007;31:6-17.]

29. Lespada MI, Córdova E, RocaV, Gómez G, Badía M, Rodríguez C. Bacteriemia por Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Estudio comparativo y evolución en 7 años. Rev Esp Quimioter. 2019 acceso 14/01/2020;32(1):15-2. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372954/]

30. Guzman-Blanco M, Labarca JA, Villegas MV, Gotuzzo E, Latin America Working Group on Bacterial Resistance. Extended spectrum ß-lactamase producers among nosocomial Enterobacteriaceae in Latin America. Braz J Infect Dis. 2014;18(4):421-33. DOI: 10.1016/j.bjid.2013.10.005]

31. Shadyab AF, Crum-Cianflone NF. Methicillin-resistant Staphylococcus aureus (MRSA) infections among HIV-infected persons in the era of highly active antiretroviral therapy: a review of the literature. HIV Medicine. 2012;13(6):319-32. DOI: 10.1111/j.1468-1293.2011.00978.x]

32. Peters PJ, Brooks JT, McAllister SK, Limbago B, Lowery HK, Fosheim J, et al Methicillin-Resistant Staphylococcus aureus Colonization of the Groin and Risk for Clinical Infection among HIV-infected Adults. Emerging Infectious Diseases. 2013;19(4):623-9. DOI: 10.3201/eid1904.121353]

33. Huson MA, Stolp SM, van der Poll T, Grobusch MP. Community-acquired bacterial bloodstream infections in HIVinfected patients: a systematic review. Clin Infect Dis. 2014;58(1):79-9. DOI: 10.1093/cid/cit596]