Pathogens and prognostic factors of severe pneumonia in AIDS patients

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Author:
DENG Xi-long(Department of Critical Care, Guangzhou No. 8 People's Hospital, Guangzhou 510060 , Guangdong Province, China)
TANG Xiao-ping(Department of Critical Care, Guangzhou No. 8 People's Hospital, Guangzhou 510060 , Guangdong Province, China)
ZHUO Li(Department of Critical Care, Guangzhou No. 8 People's Hospital, Guangzhou 510060 , Guangdong Province, China)
LI Ling-hua(Department of Critical Care, Guangzhou No. 8 People's Hospital, Guangzhou 510060 , Guangdong Province, China)
CAI Wei-ping(Department of Critical Care, Guangzhou No. 8 People's Hospital, Guangzhou 510060 , Guangdong Province, China)
CHEN Xie-jie(Department of Critical Care, Guangzhou No. 8 People's Hospital, Guangzhou 510060 , Guangdong Province, China)
Journal Title:
Chinese Journal of Clinical Infectious Diseases
Issue:
Volume 04, Issue 04, 2011
DOI:
10.3760/cma.j.issn.1674-2397.2011.04.005
Key Word:
Acquired immune deficiency syndrome;Pneumonia;Pathogen;Highly active antiretroviral therapy;Prognosis;Logistic regression

Abstract: Objective To investigate the pathogens and prognostic factors of AIDS-associated severe pneumonia. Methods Clinical data were collected from 95 patients with AIDS-associated severe pneumonia admitted to Guangzhou No. 8 People' s Hospital from January 2005 to December 2008. The pathogens of pulmonary infections were investigated. Univariate analysis and multivariate logistic regression analysis were performed to study the relationships between the outcome and influencing factors. Results The most prevalent pathogen was Pneumocystis jirovecii (64/95, 67.4% ), followed by bacteria (61/95, 64.2% ),fungi ( 50/95, 52. 6% ), mycobacterium tuberculosis ( 27/95, 28. 4% ) and cytomegalovirus ( CMV ) (25/95, 26.3% ). Among 95 cases, monocontamination was detected in 15 cases ( 15.8% ), while mixed infection in 80 cases (84. 2% ). Logistic regression analysis showed that mechanical ventilation, higher serum lactic dehydrogenase (LDH) level and severe underlying diseases were risk factors for the death of AIDS-associated severe pneumonia, and higher serum albumin level was the protective factor. Conclusion Pneumocystis jirovecii, bacteria and fungi are the main pathogens for AIDS-associated severe pneumonia, and mixed infection is popular.

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