Severe Bacterial Non-AIDS Infections in Persons With Human Immunodeficiency Virus: The Epidemiology and Evolution of Antibiotic Resistance Over an 18-Year Period (2000-2017) in the ANRS CO3 AquiVih-Nouvelle-Aquitaine Cohort.

Autor:	Blanc P; Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, Bordeaux, France., Bonnet F; Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André, Bordeaux, France.; Université de Bordeaux, INSERM, Bordeaux Population Health (BPH), U1219, Bordeaux, France., Leleux O; Université de Bordeaux, INSERM, Bordeaux Population Health (BPH), U1219, Bordeaux, France., Perrier A; Université de Bordeaux, INSERM, Bordeaux Population Health (BPH), U1219, Bordeaux, France., Bessede E; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, Bordeaux, France., Pereyre S; Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin, Bordeaux, France.; Université de Bordeaux, Centre national de la recherche scientifique (CNRS), Unité mixte de recherche (UMR) 5234 Fundamental Microbiology and Pathogenicity, Bordeaux, France., Cazanave C; Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, Bordeaux, France., Neau D; Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin, Bordeaux, France., Vareil MO; Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses, Bayonne, France., Lazaro E; Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital du Haut-Lévêque, Pessac, France., Duffau P; Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Immunologie Clinique, Hôpital Saint-André, UMR 5164, Bordeaux, France.; Université de Bordeaux, CNRS, Immuno ConcEpT, UMR 5164, Bordeaux, France., Saunier A; Centre Hospitalier de Périgueux, Service de Médecine Interne, Périgueux, France., André K; Centre Hospitalier de Dax, Service de Maladies Infectieuses, Dax, France., Wittkop L; Université de Bordeaux, Inserm, Institut Bergonié, BPH, U1219, Centre d'Investigation Clinique - Epidémiologie Clinique (CIC-EC) 1401, Bordeaux, France.; INRIA SISTM Team, Talence, France.; Centre Hospitalier Universitaire de Bordeaux, Service d'information médicale, Inserm, Institut Bergonié, CIC-EC 1401, Bordeaux, France., Vandenhende MA; Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital Pellegrin, Inserm, Institut Bergonié, CIC-EC 1401, Bordeaux, France.; Université de Bordeaux, Inserm, Institut Bergonié, CIC-EC 1401, Bordeaux, France.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 May 24; Vol. 76 (10), pp. 1814-1821.
DOI:	10.1093/cid/ciac978
Abstrakt:	Background: Severe non-AIDS bacterial infections (SBIs) are among the leading causes of hospital admissions among persons with human immunodeficiency virus (PWH) in regions with high antiretroviral therapy coverage. Methods: This large prospective cohort study of PWH examined the types of infections, bacterial documentation, and evolution of antibiotic resistance among PWH hospitalized with SBIs over an 18-year period. Results: Between 2000 and 2017, 459 PWH had at least 1 SBI with bacterial documentation. Among the 847 SBIs, there were 280 cases of bacteremia, 269 cases of pneumonia, and 240 urinary tract infections. The 1025 isolated bacteria included Enterobacteriaceae (n = 394; mainly Escherichia coli), Staphylococcus aureus (n = 153), and Streptococcus pneumoniae (n = 82). The proportion of S. pneumoniae as the causative agent in pneumonia and bacteremia decreased sharply over time, from 34% to 8% and from 21% to 3%, respectively. The overall antibiotic resistance of S. aureus and S. pneumoniae decreased progressively but it increased for Enterobacteriaceae (from 24% to 48% for amoxicillin-clavulanate, from 4% to 18% for cefotaxime, and from 5% to 27% for ciprofloxacin). Cotrimoxazole prophylaxis was associated with higher nonsusceptibility of S. pneumoniae to amoxicillin and erythromycin, higher nonsusceptibility of Enterobacteriaceae to β-lactams and fluoroquinolones, and a higher risk of extended-spectrum β-lactamase-producing Enterobacteriaceae. Conclusions: The bacterial resistance pattern among PWH between 2014 and 2017 was broadly similar to that in the general population, with the exception of a higher resistance profile of Enterobacteriaceae to fluoroquinolones. The use of cotrimoxazole as prophylaxis was associated with an increased risk of antibiotic resistance. Competing Interests: Potential conflicts of interest. F. B. reports grants or contracts from Gilead for the ANRS CO3 AquiVih Cohort study; payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events from Gilead, MSD, and ViiV Healthcare; and support for attending meetings and/or travel from Gilead, MSD, and ViiV Healthcare. S. P. reports support for conference attendance from bioMérieux and support for attending meetings and/or travel from Roche Diagnostics. A. S. reports support for attending conference from Gilead Sciences and ViiV Healthcare. M.-A. V. reports support for attending conference from Gilead. L. W. reports grants or contracts unrelated to this work from ANRS-MIE (paid to institution). All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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