Germs

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Staphylococcus aureus Colonization in Brazilian Children

by Marcelo J. Mimica and Maria Fernanda Bádue-Pereira

Germs 2014, 4(1), 22; https://doi.org/10.11599/germs.2014.1051 - 3 Mar 2014

Cited by 4 | Viewed by 58

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We read with interest the paper authored by Preoțescu LL and Streinu-Cercel O, [...] Full article

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Open AccessArticle

Disseminated Tuberculosis in HIV-Infected Patients from the Regional HIV/AIDS Center Constanța, Romania

by Sorin Rugină, Irina-Magdalena Dumitru, Ghiulendan Resul, Roxana Carmen Cernat and Andra Elena Petcu

Germs 2014, 4(1), 16-21; https://doi.org/10.11599/germs.2014.1050 - 3 Mar 2014

Cited by 9 | Viewed by 60

Abstract

Introduction: The purpose of our study was to evaluate clinical and pathological characteristics as well as treatment outcomes in HIV-infected patients with disseminated tuberculosis from the Regional HIV/AIDS Center Constanța, Romania, and to determine associated risk factors. Methods: We analyzed HIV-infected adults diagnosed with disseminated tuberculosis (TB) over the past two years, monitored in the Regional HIV/AIDS Center Constanța. Results: Out of a total number of 956 HIV-infected patients, 42 had been diagnosed with tuberculosis over the past two years (2011–2013) (4.39%) and 16 of them developed disseminated TB (38%). At the time of diagnosis, we recorded abnormal chest X-rays in 8 (50%), and positive sputum cultures in 4 (25%) of them. The median CD4 count was 40 cells/μL with a range of 5–85 cells/μL; HIV-RNA was detectable in all cases. Multi-drug-resistant tuberculosis (MDR-TB) was identified in 6 cases. The outcome was unfavorable in 15 patients. Conclusions: In our study, disseminated tuberculosis appeared to be a common pattern of evolution of HIV-TB co-infection (38%). Sputum smear positivity was low and chest X-ray images did not follow a typical pattern. HIV-TB co-infected patients with CD4 lymphocyte cell count <50 cells/μL were more likely to have disseminated TB. The severity of cases, proved by a high mortality rate, requires consideration of this diagnosis early in patients with advanced AIDS, even if laboratory investigations are not suggestive. Full article

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Open AccessArticle

Predictors of Loss to Follow-Up After Engagement in Care of HIV-Infected Children Ineligible for Antiretroviral Therapy in an HIV Cohort Study in India

by Gerardo Alvarez-Uria, Praveen Kumar Naik, Manoranjan Midde and Raghavakalyan Pakam

Germs 2014, 4(1), 9-15; https://doi.org/10.11599/germs.2014.1049 - 3 Mar 2014

Cited by 8 | Viewed by 73

Abstract

Introduction: Previous studies performed in low- and middle-income countries have shown that nearly half of HIV-infected adults not eligible for antiretroviral therapy (ART) at the time of enrolment in care are lost to follow-up (LTFU). However, data about the attrition from enrolment in care to ART eligibility of HIV-infected children are scarce, especially outside sub-Saharan Africa. Methods: This is a retrospective study about the attrition before ART eligibility of 282 children ineligible for ART at enrolment in care in a cohort study in India. Multivariate analysis was performed using competing risk regression. Results: During 5695 child-months of follow-up, three children died, 36 were LTFU and 144 became ART eligible. The cumulative incidence of attrition (mortality and LTFU) was 15.6% (95% confidence interval [CI], 11.3–20.5) at five years, and the attrition rate was higher during the first year after enrolment in care. The cumulative incidence of LTFU and mortality was 14.4% (95% CI, 10.2–19.2) and 1.2% (95% CI, 0.3–3.3) at five years, respectively. Children with a 12-month AIDS risk 4%. Those children whose father had died had a lower risk of LTFU (SHR 0.26, 95% CI 0.09–0.75) than those whose parents were alive and were living in a rented house. Children aged 10–14 had a lower risk of LTFU (SHR 0.12, 95% CI 0.03–0.55) than those aged 5–9 years. Conclusions: In our setting, a substantial proportion of children ineligible for ART are lost to follow-up before ART eligibility, especially those with younger age, less severe immunosuppression or living with parents in poor socio-economic conditions. These findings can be used by HIV programmes to design interventions aimed at reducing the attrition of pre-ART care of HIV-infected children in India. Full article

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Open AccessEditorial

Colistin in the Management of Severe Infections with Multidrug Resistant Gram-Negative Bacilli

by Adrian Streinu-Cercel

Germs 2014, 4(1), 7-8; https://doi.org/10.11599/germs.2014.1048 - 3 Mar 2014

Cited by 2 | Viewed by 58

Abstract

1933—Boivin A, Mesrobeanu I and Mesrobeanu L describe a toxic factor enclosed in the outer membrane of Gram-negative bacteria – nowadays known as endotoxin (C.R. Soc. Biol. Paris 1933;114:307).[...] Full article

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Germs, Volume 4, Issue 1 (03 2014) – 4 articles

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