China
Africa
Explore chapters and articles related to this topic
Epidemiology, Transmission, and Medical Management
Published in Judith Landau-Stanton, Colleen D. Clements, Robert E. Cole, Ann Z. Griepp, Alexander F. Tartaglia, Jackie Nudd, Elisabet Espaillat-Piña, M. Duncan Stanton, AIDS, Health, and Mental Health, 1993
Judith Landau-Stanton, Colleen D. Clements
In addition to infections occurring in women that were not included in the early definitions of AIDS in the United States, one of the primary infections resulting from HIV was not initially included, AIDS dementia complex. There may be a number of central nervous system diseases in which HIV results in a primary infection of the central nervous system, such as: aseptic meningitis, peripheral neuropathy, and AIDS dementia complex. The neurological picture will be further discussed in Chapter 7. On an international level, the defining opportunistic infections will also vary. In Brazil the most common infection is not pneumocystis pneumonia or Kaposi’s sarcoma, as in the United States, but rather toxoplasmosis. In Africa, in addition to a high rate of Kaposi’s sarcoma, tropical diseases uncommon in the United States or Central Europe are associated with HIV infection. In Australia, a report identified two equestrians who had AIDS and were treated for a rare disease usually found in horses, rhodococcus equi. “Such organisms, found in birds, deer, cats and fish and seldom causing disease in humans, will appear when there has been profound damage to the immune system,” said Graeme Stewart, president of the Australian Society of HIV Medicine.8
Vancomycin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
Inge C. Gyssens, Natasha E. Holmes
Rhodococcus equi, a veterinary pathogen, is a rare cause of serious infections in immunocompromised patients, notably those with HIV infection or AIDS (Verville et al., 1994). A combination of erythromycin and rifampicin has been considered one of the treatments of choice for this infection. However, vancomycin has good activity against the organism in vitro (Nordmann and Ronco, 1992), and in an animal model of Rhodococcus equi infection, vancomycin was the single most effective agent (Nordmann et al., 1992). Vancomycin, usually in combination with other antibiotics such as imipenem, has been used successfully to treat several patients with this infection (Rouquet et al., 1991). Vancomycin treatment for R. equi is also seen in other immunocompromised patients, such as transplant recipients and patients receiving chemotherapy for hematologic or solid organ malignancies, and has been associated with pneumonia (Yamshchikov et al., 2010; Menon et al., 2012), mediastinal lymphadenitis (Yamshchikov et al., 2010), lung abscess (Tse et al., 2008), and peritoneal dialysis-associated peritonitis (Azzam et al., 2015). A renal transplant recipient with refractory R. equi pneumonia requiring five antimicrobial agents, including vancomycin, required surgical management for a definitive cure (Ursales et al., 2014). An immunocompetent patient without HIV or disorders of cell-mediated immunity developed pulmonary and cerebral R. equi infection (Kamboj et al., 2005) that responded to combination treatment including vancomycin.
Factors determining phage stability/activity: challenges in practical phage application
Published in Expert Review of Anti-infective Therapy, 2019
Ewa Jończyk-Matysiak, Norbert Łodej, Dominika Kula, Barbara Owczarek, Filip Orwat, Ryszard Międzybrodzki, Joanna Neuberg, Natalia Bagińska, Beata Weber-Dąbrowska, Andrzej Górski
Moreover, a Rhodococcus equi REQ1 phage was tested in the solid form [153]. The phage activity was retained for 60 days in pessary/suppository form and for as long as 90 days in troche form at 4°C. Phages included in tablets and powders may ensure the maintenance of phage titer and its stability when stored in low humidity [159]. However, Ly-Chatain (2014) found that phages in solid media may have limited diffusion, which may be a possible reason for reduced absorption to bacterial cells and therapeutic failure [160]. Also the KOX1 phage active against K. oxytoca had the ability to survive in stimulated gastric conditions (0.32% (wt/vol) pepsin, pH 2.5) in a troche form [161]. It was capable of retaining stability in solid forms for 90 min when the titer was reduced from 4.5 × 108 pfu/ml to 104 pfu/ml. Interestingly, the formulations had a stable titer for at least 49 days for suppositories and as long as 56 days for troches when stored at 4°C without access to light. Furthermore, the suppositories were found to contain more than 107 pfu/ml active phages. Another form of preparation intended for healing with antibacterial potential against Pseudomonas was described by Sarhan and Azzazy (2017), who presented the possibility to use a PS1 phage at a titer 109–1010 pfu/ml loaded nanofibers containing chitosan and bee venom [162].
Treating bacterial pneumonia in people living with HIV
Published in Expert Review of Respiratory Medicine, 2019
Jerry S. Zifodya, Kristina Crothers
‘Atypical’ pathogens such as Legionella pneumophila, Mycoplasma pneumoniae, and Chlamydophila pneumoniae are less common etiologic agents with rates that are inversely proportional to CD4 cell counts [3,112]. L. pneumophila occurs up to 40 times more frequently in PLWH than in HIV-uninfected individuals [13]. PLWH with L. pneumophila, particularly those with advanced immunosuppression, often present with more severe CAP than HIV-uninfected individuals [113]. Diagnostic methods include culture, urinary antigen and real-time PCR (rtPCR) as well as serology [112,114]. Diagnosis of M. pneumoniae and C. pneumoniae can be made via nucleic acid amplification tests for increased sensitivity and expedient identification of these organisms [115]. Rhodococcus equi and Nocardia spp. are fastidious bacteria that often mimic TB infection both in indolence and imaging findings of pulmonary consolidation with cavitation. These are infrequently isolated in advanced AIDS with CD4 count less than 50 cells/µL and have become rare due to ART. Treatment for R. equi is based on antimicrobial sensitivity testing with combination therapy often required. Nocardia spp. is treated with trimethoprim-sulfamethoxazole and incidence has reduced at least in part due to prophylaxis for PCP. Nocardia spp. has a predilection for the central nervous system thus brain imaging should be carried out in any individuals diagnosed with pulmonary nocardiosis.
Bacteria Associated with Granulomatous Lobular Mastitis and the Potential for Personalized Therapy
Published in Journal of Investigative Surgery, 2022
Xin-Qian Li, Hong-Li Wu, Jing-Ping Yuan, Tian-gang Liu, Sheng-Rong Sun, Chuang Chen
Other bacteria associated with GLM have been reported. For example, Wang et al. [9] identified the five most abundant pathogenic genera in GLM as Pseudomonas, Brevundimonas, Stenotrophomonas, Acinetobacter and Aspergillus. Actinomyces has also been identified in GLM [41]. Fujii et al. [29] detected common sequences of Nocardia, Mycobacterium, Rhodococcus equi, Gordonia and Dietzia in two cases. In addition, mixed strains of Corynebacterium, Propionibacterium acnes, group B Streptococcus, and Candida were isolated in four cases [30].