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Cited by 56Salmonella and Campylobacter epidemiologyHIV/AIDS Research and InterventionsBacterial Infections and Vaccines

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Risk of Recurrent Nontyphoid Salmonella Bacteremia in HIV-Infected Patients in the Era of Highly Active Antiretroviral Therapy and an Increasing Trend of Fluoroquinolone Resistance

Hung, C.-C., Hung, M.-N., Hsueh, P.-R., Chang, S.-Y., Chen, M.-Y., Hsieh, S.-M., Sheng, W.-H., Sun, H.-Y., Huang, Y.-T., Lo, Y.-C., Hsiao, C.-F., Chang, S.-C.·2007·Clinical Infectious Diseases
DOI 10.1086/520681
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Abstract

BACKGROUND: Risk of recurrent nontyphoid Salmonella (NTS) bacteremia and trends of antimicrobial resistance of NTS remain unknown in human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy (HAART). METHODS: Ninety-three patients who received a diagnosis of NTS bacteremia from June 1994 through June 2006 were prospectively followed up. Incidence of recurrent NTS bacteremia was compared between the pre-HAART era (June 1994-March 1997) and the HAART era (April 1997-June 2006). Prevalence of antimicrobial resistance was compared among the NTS isolates obtained in the pre-HAART era, the early HAART era (April 1997-June 2002), and the late HAART era (July 2002-June 2006). RESULTS: Compared with patients enrolled in the pre-HAART era, patients who received HAART had an incidence of recurrent NTS bacteremia that was significantly reduced by 96%; the incidence of recurrent NTS bacteremia was 2.56 cases per 100 person-years in the HAART era, compared with 70.56 cases per 100 person-years in the pre-HAART era (rate ratio, 0.036; 95% confidence interval, 0.012-0.114; P<.001). In the HAART era, the incidence of recurrent NTS bacteremia did not increase among patients receiving fluoroquinolone prophylaxis for <or=30 days (1.69 cases per 100 person-years), compared with among patients receiving fluoroquinolones for >30 days (3.95 cases per 100 person-years), with a rate ratio of 0.43 (95% confidence interval, 0.07-2.58). Although resistance to ampicillin, cotrimoxazole, and chloramphenicol decreased, the proportion of NTS isolates resistant to fluoroquinolones increased from 0% in the pre-HAART era to 6.2% in the early HAART era and 34.2% in the late HAART era (P=.002). CONCLUSIONS: The risk of recurrent NTS bacteremia decreased significantly in the HAART era, although NTS isolates obtained from HIV-infected patients were increasingly resistant to fluoroquinolones.

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  • Young children (age < 5 years), older adults (age >= 65 years), immunocompromised patients, and pregnant women are at increased risk for zoonotic diseases from pets.

    “Pets are a potential source of infection, with patients who are immunocompromised, pregnant women, young children and older adults at the greatest risk for transmission.”

    From Reducing the risk of pet-associated zoonotic infections (2015) · cites this paper as [13]

    The Discussion (page not provided) links low CD4 counts in HIV-infected patients to a high risk of recurrent nontyphoid Salmonella bacteremia, supporting a narrow point about immunocompromise. It does not address transmission from pets or identify pregnant women, children under five, and adults 65 or older as groups at greatest risk. (LLM, conf=0.84)

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  • High-risk groups may have more severe disease, longer symptom duration, or more severe complications than other patients.

    “may have more severe disease, may have symptoms for a longer duration, or may have more severe complications than other patients. 13-15”

    From Reducing the risk of pet-associated zoonotic infections (2015) · cites this paper as [13]

    The Results section (“Prevalence of NTS bacteremia and incidence rate of recurrent NTS bacteremia”; page unavailable) documents recurrent bacteremia in HIV-infected patients, and the Discussion links recurrence risk to low CD4 counts. This supports a risk of serious recurrence in the group studied, but the paper does not establish that high-risk groups generally have longer-lasting symptoms or more severe disease or complications than other patients. (LLM, conf=0.79)

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Metadata

Authors
Hung, C.-C., Hung, M.-N., Hsueh, P.-R., Chang, S.-Y., Chen, M.-Y., Hsieh, S.-M., Sheng, W.-H., Sun, H.-Y., Huang, Y.-T., Lo, Y.-C., Hsiao, C.-F., & Chang, S.-C.
Affiliations
  • National Taiwan University (TW)
  • National Health Research Institutes (TW)
Corresponding author
Hung, C.-C.
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2007-09-01
Volume
45
Issue
5
Pages
e60-e67
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/520681
OpenAlex
W2156267790
Cited by
56
References
0
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 6 · 2020: 4 · 2019: 4 · 2016: 2 · 2015: 6 · 2014: 2 · 2012: 3
FWCI
6.51
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Keywords
HIV infection, highly active antiretroviral therapy, fluoroquinolone resistance, fluoroquinolone prophylaxis, antimicrobial resistance, ampicillin resistance, trimethoprim-sulfamethoxazole resistance, chloramphenicol resistance, Salmonella serotypes, HIV-associated opportunistic infections
MeSH terms
Adult, Female, Follow-Up Studies, Humans, Male, Microbial Sensitivity Tests, Middle Aged, Recurrence, Salmonella Infections, Taiwan, HIV Infections, Incidence, Bacteremia, Antiretroviral Therapy, Highly Active, Fluoroquinolones, Drug Resistance, Multiple, Bacterial, Anti-Retroviral Agents

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