國家衛生研究院 NHRI:Item 3990099045/1809
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/1809


    Title: Risk of recurrent nontyphoid Salmonella bacteremia in HIV-infected patients in the era of highly active antiretroviral therapy and an increasing trend of fluoroquinolone resistance
    Authors: Hung, CC;Hung, MN;Hsueh, PR;Chang, SY;Chen, MY;Hsieh, SM;Sheng, WH;Sun, HY;Huang, YT;Lo, YC;Hsiao, CF;Chang, SC
    Contributors: Division of Biostatistics and Bioinformatics
    Abstract: Background. Risk of recurrent nontyphoid Salmonella (NTS) bacteremia and trends of antimicrobial resistance of NTS remain unknown in human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy (HAART). Methods. Ninety-three patients who received a diagnosis of NTS bacteremia from June 1994 through June 2006 were prospectively followed up. Incidence of recurrent NTS bacteremia was compared between the pre-HAART era (June 1994-March 1997) and the HAART era (April 1997-June 2006). Prevalence of antimicrobial resistance was compared among the NTS isolates obtained in the pre-HAART era, the early HAART era (April 1997-June 2002), and the late HAART era (July 2002-June 2006). Results. Compared with patients enrolled in the pre-HAART era, patients who received HAART had an incidence of recurrent NTS bacteremia that was significantly reduced by 96%; the incidence of recurrent NTS bacteremia was 2.56 cases per 100 person-years in the HAART era, compared with 70.56 cases per 100 person-years in the pre-HAART era (rate ratio, 0.036; 95% confidence interval, 0.012-0.114; P < .001). In the HAART era, the incidence of recurrent NTS bacteremia did not increase among patients receiving fluoroquinolone prophylaxis for <= 30 days (1.69 cases per 100 person-years), compared with among patients receiving fluoroquinolones for > 30 days (3.95 cases per 100 person-years), with a rate ratio of 0.43 (95% confidence interval, 0.07-2.58). Although resistance to ampicillin, cotrimoxazole, and chloramphenicol decreased, the proportion of NTS isolates resistant to fluoroquinolones increased from 0% in the pre-HAART era to 6.2% in the early HAART era and 34.2% in the late HAART era (P = .002) Conclusions. The risk of recurrent NTS bacteremia decreased significantly in the HAART era, although NTS isolates obtained from HIV-infected patients were increasingly resistant to fluoroquinolones.
    Keywords: Immunology;Industrial Relations & Labor;Infectious Diseases;Microbiology
    Date: 2007-09-01
    Relation: Clinical Infectious Diseases. 2007 Sep;45(5):E60-E67.
    Link to: http://dx.doi.org/10.1086/520681
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1058-4838&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000248557000043
    Cited Times(Scopus): http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=34548459832
    Appears in Collections:[Chin-Fu Hsiao] Periodical Articles

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