Journal Article

Trends in Bloodstream Infections among Human Immunodeficiency Virus-Infected Adults Admitted to a Hospital in Nairobi, Kenya, during the Last Decade

Gilly Arthur, Videlis N. Nduba, Samuel M. Kariuki, Joseph Kimari, Shrikant M. Bhatt and Charles F. Gilks

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 2, pages 248-256
Published in print July 2001 | ISSN: 1058-4838
Published online July 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/321820
Trends in Bloodstream Infections among Human Immunodeficiency Virus-Infected Adults Admitted to a Hospital in Nairobi, Kenya, during the Last Decade

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Bloodstream infections are a frequent complication in human immunodeficiency virus (HIV)-infected adults in Africa and usually associated with a poor prognosis. We evaluated bloodstream infections across a decade in 3 prospective cross-sectional surveys of consecutive medical admissions to the Kenyatta National Hospital, Nairobi, Kenya. Participants received standard clinical care throughout. In 1988–1989, 29.5% (28 of 95) of HIV-positive patients had bloodstream infections, compared with 31.9% (46 of 144) in 1992 and 21.3% (43 of 197) in 1997. Bacteremia and mycobacteremia were significantly associated with HIV infection. Infections with Mycobacterium tuberculosis, non-typhi species of Salmonella (NTS), and Streptococcus pneumoniae predominated. Fungemia exclusively due to Cryptococcus neoformans was uncommon. Clinical features at presentation remained similar. Significant improvements in the survival rate were recorded among patients with NTS bacteremia (20%–83%; P < .01) and mycobacteremia (0%–73%; P < .01). Standard clinical management can improve outcomes in resource-poor settings.

Journal Article.  4977 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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