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Schleenvoigt, Benjamin T.; Ankert, Juliane; Barten-Neiner, Grit; Voit, Florian; Suttorp, Norbert; Boesecke, Christoph; Hoffmann, Christian; Stolz, Daiana; Pletz, Mathias W.; Rohde, Gernot; Witzenrath, Martin; Panning, Marcus; Essig, Andreas; Rupp, Jan; Degen, Olaf; Stephan, Christoph; Dreher, M.; Cornelissen, C.; Knüppel, W.; Creutz, P.; Mikolajewska, A.; le Claire, A.; Benzke, M.; Bauer, T.; [...]

Pathogen spectrum of community acquired pneumonia in people living with HIV (PLWH) in the German CAPNETZ-Cohort

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  • Media type: E-Article
  • Title: Pathogen spectrum of community acquired pneumonia in people living with HIV (PLWH) in the German CAPNETZ-Cohort
  • Contributor: Schleenvoigt, Benjamin T.; Ankert, Juliane; Barten-Neiner, Grit; Voit, Florian; Suttorp, Norbert; Boesecke, Christoph; Hoffmann, Christian; Stolz, Daiana; Pletz, Mathias W.; Rohde, Gernot; Witzenrath, Martin; Panning, Marcus; Essig, Andreas; Rupp, Jan; Degen, Olaf; Stephan, Christoph; Dreher, M.; Cornelissen, C.; Knüppel, W.; Creutz, P.; Mikolajewska, A.; le Claire, A.; Benzke, M.; Bauer, T.; [...]
  • Published: Springer Science and Business Media LLC, 2024
  • Published in: Infection, 52 (2024) 1, Seite 129-137
  • Language: English
  • DOI: 10.1007/s15010-023-02070-3
  • ISSN: 0300-8126; 1439-0973
  • Keywords: Infectious Diseases ; Microbiology (medical) ; General Medicine
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Objectives</jats:title> <jats:p>The objective of this study was to identify the pathogen spectrum of community acquired pneumonia in people living with HIV (PLWH), and to compare it with a matched HIV negative group in order to reassess therapeutic strategies for PLWH.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Seventy-three (n = 73) PLWH (median CD4 3–6 months before CAP: 515/µl; SD 309) with community acquired pneumonia (CAP) were matched with 218 HIV-negative CAP controls in a prospective study design. Pathogen identifications used blood culture, samples from the upper and lower respiratory tract (culture and multiplex PCR) and urinary pneumococcal and legionella antigen test.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Although the vaccination rate among PLWH with CAP was significantly higher (pneumococcal vaccination: 27.4 vs. 8.3%, p &lt; 0.001; influenza vaccination: 34.2 vs. 17.4%, p = 0.009), pneumococci were found most frequently as pathogen among both PLWH (n = 19/21.3%) and controls (n = 34/17.2%; p = 0.410), followed by <jats:italic>Haemophilus influenzae</jats:italic> (PLWH, n = 12/13.5%, vs. controls, n = 25 / 12.6%; p = 0.850). <jats:italic>Staphylococcus aureus</jats:italic> was found equally in 20.2 and 19.2% in PLWH and controls, but infection or colonization could not be distinguished. Mortality during 6-month follow-up was significantly higher for PLWH (5/73, or 6.8%) versus controls (3/218, or 1.4%), however with lower case numbers than previously reported. Typical HIV-associated pathogens such as <jats:italic>Pneumocystis jirovecii</jats:italic> were found only exceptionally.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Our study underscores the persistent clinical burden of CAP for PLWH. From pathogen perspective, empirical antibiotic treatment for CAP in PLWH on antiretroviral therapy should cover pneumococci and <jats:italic>Haemophilus influenzae</jats:italic> and may be adopted from valid common recommendations<jats:italic>.</jats:italic></jats:p> </jats:sec>