Article,

Colonization by Streptococcus pneumoniae among human immunodeficiency virus-infected adults: prevalence of antibiotic resistance, impact of immunization, and characterization by polymerase chain reaction with BOX primers of isolates from persistent S. pneumoniae carriers

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The Journal of Infectious Diseases, 175 (3): 590--7 (March 1997)PMID: 9041330.

Abstract

Pharyngeal colonization by Streptococcus pneumoniae was evaluated in 103 human immunodeficiency virus (HIV)-infected subjects (\textless200 CD4 cells/microL, 57; \textgreater or = 200 CD4 cells/microL, 46) and 39 non-HIV-infected controls who were participants in a vaccine study. At baseline, 7\%, 20\%, and 10\% of subjects in the \textless200 and \textgreater or = 200 CD4 cell groups and in the control group were colonized with S. pneumoniae: Rates at 6 months were 23\%, 22\%, and 0\%, respectively. Of 34 isolates from HIV-infected subjects, 25 were penicillin-resistant and 19 were resistant to \textgreater or = 3 antimicrobials; of 8 isolates from controls, 1 was resistant. Resistance to trimethoprim-sulfamethoxazole was significantly higher among HIV-infected subjects with \textless200 CD4 cells/microL than in those with more CD4 cells. Polymerase chain reaction DNA analysis with BOX primers demonstrated that 12 HIV-infected subjects were persistently colonized with the same S. pneumoniae strain for \textgreater or = 1 month compared with none of the controls. HIV-infected subjects were more likely to be persistent pneumococcal carriers and to carry antibiotic-resistant isolates than were non-HIV-infected subjects.

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