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. 1997 Sep 8;157(16):1869-73.
doi: 10.1001/archinte.1997.00440370111012.

Haemophilus species bacteremia in adults. The importance of the human immunodeficiency virus epidemic

P Muñoz  1 , M E Miranda, A Llancaqueo, T Peláez, M Rodríguez-Créixems, E Bouza
Affiliations

Haemophilus species bacteremia in adults. The importance of the human immunodeficiency virus epidemic

P Muñoz et al. Arch Intern Med. .

Abstract

Background: Until the late 1970s, invasive infections caused by Haemophilus species were thought to occur mainly in children and only infrequently in adults.

Objective: To report the largest series to date of Haemophilus species bacteremia (HB) from a single center.

Design: Retrospective.

Setting: Large, tertiary care, general teaching hospital.

Methods: We reviewed the charts of adult patients with HB detected from January 1, 1986, to December 31, 1994. Haemophilus strains were serotyped, and the antimicrobial resistance pattern was analyzed.

Results: One hundred sixteen patients had HB (0.26 cases per 1000 admissions). Thirty-eight children and 16 adults were excluded. Human immunodeficiency virus (HIV) infection was the most common underlying condition (n = 18 [29%]), followed by malignant neoplasms (n = 12 [19%]) and chronic obstructive pulmonary disease (n = 12 [19%]). Prevalence in HIV-positive patients was 5 cases per 1000 admissions vs 0.2 cases per 1000 admissions in HIV-negative patients. Infection was nosocomial in 16 patients (26%). Focal diseases were pneumonia in 41 patients (66%), cholangitis in 5 patients (8%), endocarditis in 3 patients (5%), meningitis and septic arthritis each in 1 patient (2%), and primary bacteremia in 9 patients (14%). The HIV-positive patients were significantly younger and presented more frequently with pneumonia (P < .05). Overall, 14 patients died (22%). Bacteremia was polymicrobial in 11 patients (18%). Haemophilus influenzae was isolated in 53 patients (85%). Rates of antimicrobial resistance were 11% to chloramphenicol sodium succinate, 48% to ampicillin sodium, 78% to erythromycin stearate, 76% to combined sulfamethoxazole and trimethoprim, 15% to rifampin, and 57% to clarithromycin.

Conclusions: Infection with HIV has become the most common underlying disease in adults with HB in our hospital. Therapeutic approaches must take into account the high rate of antimicrobial resistance.

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