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
Author:
Blanc Peggy1, Bonnet Fabrice12, Leleux Olivier2, Perrier Adélaïde2, Bessede Emilie3, Pereyre Sabine34, Cazanave Charles5, Neau Didier5, Vareil Marc-Olivier6, Lazaro Estibaliz7, Duffau Pierre89, Saunier Aurélie10, André Katell11, Wittkop Linda121314, Vandenhende Marie-Anne1516ORCID, Bellecave P, Blanco P, Bonnet F, Bouchet S, Breilh D, Cazanave C, Desjardin S, Gaborieau V, Gimbert A, Hessamfar M, Lacaze-Buzy L, Lacoste D, Lafon M E, Lawson-Ayayi S, Lazaro E, Leleux O, Marec F Le, Moal G Le, Malvy D, Marchand L, Mercié P, Neau D, Pellegrin I, Perrier A, Petrov-Sanchez V, Vareil M O, Wittkop L, Bernard N, Bonnet F, Bronnimann D, Chaussade H, Dondia D, Duffau P, Faure I, Hessamfar M, Mercié P, Morlat P, Mériglier E, Paccalin F, Riebero E, Rivoisy C, Vandenhende M A, Barthod L, Cazanave C, Dauchy F A, Desclaux A, Ducours M, Dutronc H, Duvignaud A, Leitao J, Lescure M, Neau D, Nguyen D, Malvy D, Pistone T, Puges M, Wirth G, Courtault C, Camou F, Greib C, Lazaro E, Pellegrin J L, Rivière E, Viallard J F, Imbert Y, Thierry-Mieg M, Rispal P, Caubet O, Ferrand H, Tchamgoué S, Farbos S, Vareil M O, Wille H, Andre K, Caunegre L, Gerard Y, Osorio-Perez F, Chossat I, Iles G, Gerard Y, Labasse-Depis M, Lacassin F, Barret A, Courtault C, Castan B, Koffi J, Rouanes N, Saunier A, Zabbe J B, Dumondin G, Gaborieau V, Gerard Y, Beraud G, Moal G Le, Catroux M, Garcia M, Giraud V, Martellosio J P, Roblot F, Pasdeloup T, Riché A, Grosset M, Males S, Bell C Ngo, Pasdeloup T, Blanco P, Pellegrin I, Carpentier C, Pellegrin I, Bellecave P, Lafon M E, Tumiotto C, Bouchet S, Breilh D, Miremeont-Salamé G, Arma D, Arnou G, Blaizeau M J, Camps P, Decoin M, Delveaux S, Diarra F, Gabrea L, Lawson-Ayayi S, Lenaud E, Plainchamps D, Pougetoux A, Uwamaliya B, Zara K, Conte V, Gapillout M, Leleux O, Perrier A, Peyrouny-Mazeau A,
Affiliation:
1. Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Maladies Infectieuses, Hôpital Saint-André , Bordeaux , France 2. Université de Bordeaux, INSERM, Bordeaux Population Health (BPH) , U1219, Bordeaux , France 3. Centre Hospitalier Universitaire de Bordeaux, Laboratoire de Bactériologie, Hôpital Pellegrin , Bordeaux , France 4. Université de Bordeaux, Centre national de la recherche scientifique (CNRS), Unité mixte de recherche (UMR) 5234 Fundamental Microbiology and Pathogenicity , Bordeaux , France 5. Centre Hospitalier Universitaire de Bordeaux, Service des maladies Infectieuses et Tropicales, Hôpital Pellegrin , Bordeaux , France 6. Centre Hospitalier de la Côte Basque, Service de Maladies Infectieuses , Bayonne , France 7. Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital du Haut-Lévêque , Pessac , France 8. Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne et Immunologie Clinique , Hôpital Saint-André, UMR 5164, Bordeaux , France 9. Université de Bordeaux, CNRS, Immuno ConcEpT, UMR 5164 , Bordeaux , France 10. Centre Hospitalier de Périgueux, Service de Médecine Interne , Périgueux , France 11. Centre Hospitalier de Dax, Service de Maladies Infectieuses , Dax , France 12. Université de Bordeaux, Inserm, Institut Bergonié, BPH, U1219, Centre d'Investigation Clinique – Epidémiologie Clinique (CIC-EC) 1401 , Bordeaux , France 13. INRIA SISTM Team , Talence , France 14. Centre Hospitalier Universitaire de Bordeaux, Service d’information médicale, Inserm, Institut Bergonié , CIC-EC 1401, Bordeaux , France 15. Centre Hospitalier Universitaire de Bordeaux, Service de Médecine Interne, Hôpital Pellegrin, Inserm, Institut Bergonié , CIC-EC 1401, Bordeaux , France 16. Université de Bordeaux, Inserm, Institut Bergonié, CIC-EC 1401 , Bordeaux , France
Abstract
Abstract
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.
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,Microbiology (medical)
Cited by
1 articles.
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