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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



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Impact of Trimethoprim-Sulfamethoxazole Prophylaxis on Etiology and Susceptibilities of Pathogens Causing Human Immunodeficiency Virus-Associated Bacteremia [Wininger DA and Fass RJ AAC 2002;46:594] The authors report an analysis of 124 episodes of bacteremia and analyzed results according to use or non-use of TMP-SMX. The most frequent blood culture isolates were S. epidermidis (50 cases), P. aeruginosa, S. aureus, E. coli, and Enterococcus. There was a trend toward decreased infections with S. aureus and coliforms in those receiving TMP-SMX prophylaxis, but it was not statistically significant. Isolates from patients receiving prophylaxis showed a frequency of resistance to this drug of 75% compared to 33% in those not receiving TMP-SMX.
Comment: Prior reports have shown a reduction in the frequency of bacteremia with salmonella and S. pneumoniae with TMP-SMX prophylaxis for PCP [AIDS 1996;10:1635]. The association with resistance in recipients of this prophylaxis has also been shown [JID 1999;180:1809]. Most of the patients in the current report had IV lines, which explains the high rates of S. epidermidis. The late Bob Fass was a co-author on this report.
posted 2/08/2002





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