This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Forrest, G. N. Articles by Gilliam, B. L. PubMed PubMed Citation Articles by Forrest, G. N. Articles by Gilliam, B. L. Social Bookmarking                         What's this?

Lack of Fluoroquinolone Resistance in Non-Typhoidal Salmonella Bacteremia in HIV-Infected Patients in an Urban US Setting

Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland

Lee-Ann M. Wagner, MD

Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland

Rohit Talwani, MD

Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland

Bruce L. Gilliam, MD

Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, bgilliam{at}ihv.umaryland.edu

Non-typhoidal salmonella (NTS) bacteremia is a significant cause of morbidity and mortality in HIV-infected individuals worldwide. Recent reports have noted increasing resistance of NTS isolates to fluoroquinolones, the recommended first-line therapy for NTS bacteremia. The outcomes and risk factors for NTS bacteremia in HIV-infected patients in an urban US setting were evaluated. From January 2002 to December 2006, 26 episodes of NTS bacteremia were identified in 16 patients. The risk factors for NTS bacteremia were low CD4 count, high viral load, and lack of antiretroviral therapy (ART). Recurrences appeared related to lack of immune reconstitution in patients not on ART. Unlike reports from Asia, no fluoroquinolone resistance was identified in any of the Salmonella strains isolated in this setting. Optimal treatment of NTS in the HIV-infected patient in the United States should include therapy with fluoroquinolones as well as attaining complete viral suppression and immune reconstitution with ART.

Key Words: HIV • non-typhoidal salmonella • bacteremia • quinolones • resistance

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 8, No. 6, 338-341 (2009)
DOI: 10.1177/1545109709352883


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?