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Pneumonia due to antibiotic resistant Streptococcus pneumoniae and Pseudomonas aeruginosa in the HAART era

¹ Department of Microbiology, Chelsea and Westminster Hospital, London
² Department of HIV Medicine, Chelsea and Westminster Hospital, London
³ Department of HIV Medicine and Department of Immunology, Chelsea and Westminster Hospital, London

Correspondence to:
Correspondence to:
Dr J Stebbing
Department of Immunology, Chelsea and Westminster Hospital, London SW1 9NH, UK; j.stebbing{at}ic.ac.uk

Antibiotic resistance profiles are useful in directing therapeutic strategies during bacterial infections. Patterns of antimicrobial resistance in Streptococcus pneumoniae and Pseudomonas aeruginosa associated pneumonia were investigated in an HIV-1 infected cohort during the era of highly active antiretroviral therapy. The median CD4 count at presentation was significantly lower for cases of P aeruginosa than for S pneumoniae. However, the number of antibiotic resistant cases of P aeruginosa decreased throughout the study period, while the incidence of S pneumoniae remained unchanged. In contrast to pneumococcal pneumonia, we show that antiretrovirals have protected from pneumonia due to antibiotic resistant P aeruginosa. These findings have implications for the treatment of individuals presenting with serious infections in which antibiotic therapy needs to be instituted before identification and sensitivities are known.

Keywords: HAART; HIV; pneumonia; antibiotic resistance

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