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Cited by 254Pneumonia and Respiratory InfectionsHIV/AIDS Research and InterventionsAntibiotic Resistance in Bacteria

Increased disease burden and antibiotic resistance of bacteria causing severe community-acquired lower respiratory tract infections in human immunodeficiency virus type 1-infected children

Madhi, S. A., Petersen, K., Madhi, A., Khoosal, M., Klugman, K. P.·2000·Clinical Infectious Diseases
DOI 10.1086/313925
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Abstract

To improve the management of lower respiratory tract infections (LRTI) in human immunodeficiency virus type 1 (HIV-1)-infected children, we assessed the burden of disease, clinical outcome and antibiotic susceptibility of bacteria causing severe community-acquired LRTI in children. A prospective, descriptive study was performed in the pediatric wards at a secondary and tertiary care hospital in South Africa. Urban black children aged 2-60 months admitted with severe acute LRTI from March 1997 through February 1998 were enrolled. HIV-1 infection was present in 45.1% of 1215 cases of severe LRTI. Bacteremia occurred in 14.9% of HIV-1-infected and in 6.5% of HIV-1-uninfected children (P<.00001). The estimated relative incidence of bacteremic severe LRTI in children aged from 2 to 24 months were greater in HIV-1-infected than in -uninfected children for Streptococcus pneumoniae (risk ratio [RR], 42.9; 95% confidence interval [CI], 20.7-90.2), Haemophilus influenzae type b (RR, 21.4; 95% CI, 9.4-48.4), Staphylococcus aureus (RR, 97.9; 95% CI, 11.4-838.2) and Escherichia coli (RR, 49.0; 95% CI, 15.4-156). Isolation of Mycobacterium tuberculosis was also more common in HIV-1-infected than in -uninfected children (RR, 22.5; 95% CI, 13.4-37.6). In HIV-1-infected children, 60% of S. aureus and 85.7% of E. coli isolates were resistant to methicillin and trimethoprim-sulfamethoxazole, respectively. The case-fatality rates among HIV-1-infected children was 13.1%, and among HIV-1-uninfected children, 2.1% (adjusted odds ratio [AOR]; 6.52, 95% CI, 3.53-12.05; P<.00001). The changing spectrum of bacteria and antibiotic susceptibility patterns in HIV-1-infected children requires a reevaluation of the empirical treatment of community-acquired severe LRTI in children from developing countries with a high prevalence of childhood HIV-1 infection.

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Crossref · 10.1086/313925

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  • HIV-infected children have a greatly increased risk of pneumonia, particularly bacterial pneumonia caused by S pneumoniae and H influenzae.

    “Children infected with HIV have a greatly increased risk of pneumonia, particularly bacterial pneumonia (S pneumoniae and H influenzae).61”

    From Global burden of childhood pneumonia and diarrhoea (2013) · cites this paper as [61]

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Authors
Madhi, S. A., Petersen, K., Madhi, A., Khoosal, M., & Klugman, K. P.
Affiliations
  • University of the Witwatersrand (ZA)
  • South African Institute for Medical Research (ZA)
Corresponding author
Madhi, S. A.
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2000-07-01
Volume
31
Issue
1
Pages
170-176
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/313925
OpenAlex
W2098698934
Cited by
254
References
24
Citations by year
2026: 1 · 2025: 1 · 2024: 1 · 2023: 5 · 2022: 7 · 2021: 7 · 2020: 4 · 2019: 9 · 2018: 5 · 2017: 7 · 2016: 14 · 2015: 16 · 2014: 12 · 2013: 12 · 2012: 12
FWCI
6.68
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Epidemiology › Pneumonia and Respiratory Infections
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
Keywords
HIV-1 infection, pediatric lower respiratory tract infection, community-acquired pneumonia, bacteremia, Streptococcus pneumoniae, Haemophilus influenzae type b, Staphylococcus aureus, Escherichia coli, Mycobacterium tuberculosis, antibiotic resistance, methicillin resistance, trimethoprim-sulfamethoxazole resistance, case fatality, disease burden
MeSH terms
Child, Preschool, Drug Resistance, Microbial, Haemophilus Infections, Haemophilus influenzae, Humans, Infant, Mycobacterium tuberculosis, Pneumonia, Pneumococcal, Prospective Studies, Staphylococcal Infections, Tuberculosis, Pulmonary, HIV-1, Bacteremia, AIDS-Related Opportunistic Infections, Community-Acquired Infections, Pneumonia, Bacterial

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