Jpn. J. Infect. Dis., 65 (1), 28-32, 2012

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Sasisopin Kiertiburanakul¹*, Siripen Watcharatipagorn¹, Piriyaporn Chongtrakool², and Pitak Santanirand²

¹Department of Medicine and ²Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

(Received June 10, 2011. Accepted October 31, 2011)

*Corresponding author: Mailing address: Department of Medicine, Faculty of Medicine Ramathibodi Hospital, 270 Rama VI Rd., Bangkok 10400, Thailand. Tel: +662 201 0033, Fax: +662 201 2232, E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

SUMMARY: Few studies have described the pattern of bloodstream infections (BSI) among HIV-infected patients in the highly active antiretroviral therapy (HAART) era, particularly in resource-limited settings. A retrospective cohort study was conducted among 140 HIV-infected patients who had a positive blood culture from 2004–2008. Of the 140 patients, 91 (65%) were male with a mean (SD) age of 38 (9.1) years and a median (IQR) CD4 cell count of 32 (9–112) cells/mm³. Community-acquired infection was detected in 89% of patients. The blood cultures contained Gram-negative bacteria, 40%; fungi, 24%; Mycobacterium spp., 20%; and Gram-positive bacteria, 16%. Common causative pathogens were Cryptococcus neoformans, 21%; Salmonella spp., 15%; and Mycobacterium tuberculosis, 12%. Common focal sites of infection were the central nervous system, 24%; respiratory tract, 20%; and gastrointestinal tract, 18%. CD4 cell count (OR, 0.61 per 50 cells/mm³ increment; 95% CI, 0.39–0.96; P = 0.031) was the only factor associated with mycobacterial or fungal BSI. The crude mortality was 21%. HAART (OR, 0.23; 95% CI, 0.01–0.77; P = 0.017), focal infection (OR, 0.31; 95% CI, 0.10–0.97; P = 0.044), and complication (e.g., shock) (OR, 9.26; 95% CI, 3.25–26.42; P < 0.001) were the predictive factors of mortality. In conclusion, opportunistic infections are still the leading causes of BSI among HIV-infected patients in the HAART era.