43rd ICAAC
A meeting of the American Society for Microbiology

September 14-17, 2003, Chicago, IL


For more information on any presentation at the 43rd ICAAC contact Jim Sliwa, ASM Office of Communications at jsliwa@asmusa.org



EMBARGOED UNTIL:  Wednesday, September 17, 8:30 a.m.

(Session 197, Paper H-1923)

Douglas Salvador
Beth Israel Deaconess Medical Center
Boston, MA, United States
Phone: 617 667-5896


Treating infections caused by antibiotic resistant bacteria is a problem in American hospitals. Since 1996 when triple-drug therapy became available, more persons with HIV have died from chronic diseases and common bacterial illnesses rather than from HIV-associated complications. Douglas Salvador, MD, a fellow in infectious diseases, and Erika D’Agata, MD, MPH, an infectious diseases faculty member, both at Beth Israel Deaconess Medical Center in Boston, MA, studied the bacteria found in persons with HIV between 1994 and 2002. Some common bacteria were found less frequently in persons with HIV infection compared to those without. They did find an increase in the bacteria that were antibiotic-resistant.

Dr. Salvador is funded by an NIH T32 HIV clinical research fellowship grant. The work is being presented at the 43rd annual Interscience Conference on Antimicrobial Agents and Chemotherapy in Chicago, Illinois on Wednesday, September 17, 2003.

Infections with bacteria that are resistant to antibiotics cause more harm and cost more money to treat than infections by susceptible bacteria. There is some evidence that HIV-positive patients have more antibiotic-resistant bacteria based on studies done before 1996. Drs. Salvador and D’Agata analyzed electronic hospital records for the number of times bacteria were found in patients with and without HIV infection. HIV-positive patients had the common skin bacteria Staphylococcus aureus, Escherichia coli (E. coli), and the family of gastrointestinal bacteria called Enterobacteriaciae less often than HIV-negative patients after 1996.

The rates of antibiotic resistance were also compared. For E. coli, a common cause of urinary tract and abdominal infections, there was more resistance to Bactrim and ampicillin, commonly used antibiotics. In another common urinary tract bacterium, klebsiella, resistance to Bactrim was also higher. The resistance in pseudomonas, a cause of hospital infections, was the same in both groups. HIV-positive patients have a greater chance of harboring one of these antibiotic resistant bacteria.

A higher rate of antimicrobial resistance may be because HIV-positive patients receive more antibiotic therapy than patients without HIV. This study highlights the need for judicious and appropriate prescribing of antibiotics in HIV-positive patients. Dr. Salvador and D’Agata are continuing to analyze these trends for other bacteria and hope to develop strategies to reduce antibiotic resistance and more effectively treat HIV-positive patients who are infected with them.



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