Pseudomonas infections in children with human immunodeficiency virus infection

Authors:
  • KBKarina M. Butler
    Karina M. Butler
  • RHRobert N. Husson
    Robert N. Husson
  • BMBrigitta U. Mueller
    Brigitta U. Mueller
  • LLLinda L. Lewis
    Linda L. Lewis
  • PPPhilip A. Pizzo
    Philip A. Pizzo
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Abstract
Thirteen bacteremias and 25 nonbacteremic infections caused by Pseudomonas spp. occurred in 22 of 236 children with human immunodeficiency virus infection with a rate of infection of 0.098 (bacteremia, 0.030) per patient year. Four patients were neutropenic (less than 500/microliters). Central venous catheter (CVC)-related infections were most frequent (n = 20) followed by otitis externa (n = 6) and pneumonia (n = 5). Pseudomonas aeruginosa was the most common isolate and caused both CVC-related and CVC-unrelated infections, whereas other Pseudomonas spp. and Xanthomonas maltophilia were almost exclusively associated with CVC-related infections. The children who received appropriate therapy had a favorable outcome. In 7 CVC-related infections (35%) the catheter was removed. Pseudomonas spp. are of increasing importance in human immunodeficiency virus-infected children causing significant morbidity and increased hospitalization. These infections may be life-threatening if appropriate therapy is not vigorously initiated.