PURPOSE: To assess the frequency of positive blood cultures among diagnosed cases of community acquired pneumonia (CAP) in HIV positive (+) patients and to compare this data with our previous study done on HIV negative (-) group with CAP in 2006. CAP was diagnosed on the bases of symptoms of cough , phlegm , fever on admission and CXR evidence of an infiltrate.
METHODS: We retrospectively reviewed the records of 364 HIV+ patients admitted with CAP in our hospital between Jan 2007 and Aug 2009 (198 males, 166 females; age range 18 to 65). All patients had CD4 counts less than 500. We excluded 17 patients for whom the blood cultures were not drawn. All patients were adequately treated according to CAP treatment guidelines and had their blood cultures drawn within the first 4 hours of ED admission.
RESULTS: Of 347 patients with CAP on which blood cultures were done, 55 patients (15.8%) had positive blood cultures. The most frequent pathogen was S. pneumonia (18 patients, 32.72%), with remaining organisms in descending order of frequency being S.aureus 12 (21.81%), H influenza 6(10.9%), Klebsiella 5(9%), E.coli 4(7.2%), Proteus 3(5.4%), corynebacterium 3(5.4%), Bacillus species 2(3.6%) and Candida albicans 2(3.6%). Unlike our previous study done on HIV- patients with CAP, in which all blood cultures were negative, this study did show positive blood cultures in immunocompromised patients.
CONCLUSION: Positive blood cultures in patients with CAP remains more frequent in patients with HIV compared to non HIV.
CLINICAL IMPLICATIONS: Inclusion of mandatory blood cultures in hospitalized patients with CAP seems appropriate for patients with HIV as opposed to non HIV individuals.
DISCLOSURE: Fawad Chaudry, No Financial Disclosure Information; No Product/Research Disclosure Information