Setting: Yaounde Central Hospital, Jamot Hospital, Yaounde, and CEBEC Hospital in Douala.
Objective: To determine and compare the bacterial aetiology and outcome of acute community-acquired pneumonia in adult patients with and those without the Human Immunodeficiency Virus (HIV) infection.
Design: We studied 110 consecutive adult patients admitted for pneumonia into three hospitals in Cameroon, from November 1991 to December 1992. Blood cultures, sputum microscopy and cultures as well as pneumococcal antigen detection in sera and sputum were performed. Serological analysis for HIV, Mycoplasma pneumoniae, Coxiella burnetti and Chlamydia pneumoniae was also done.
Results: Twenty-eight (25.5%) of the 110 patients were HIV positive. Streptococcus pneumoniae was the most common single bacterial aetiology in the two groups. Bacteremia was observed in 12 (15.0%) of 80 patients on whom blood cultures were done and was significantly more common in HIV seropositive than seronegative patients. Mortality was the same in the two groups.
Conclusion: There were no differences in aetiology and outcome between HIV seropositive and seronegative patients. However, bacteremia occurred more significantly in the HIV seropositive group.
PIP: During November 1991 to December 1992, in Cameroon, infectious disease specialists examined blood samples and/or sputum samples of 110 patients aged 15 years or older admitted for acute community-acquired pneumonia to Yaounde Central Hospital and Jamot Hospital in Yaounde and to CEBEC Hospital in Douala. They aimed to determine and compare the etiology and outcome of acute community-acquired pneumonia in HIV-infected and non-HIV-infected adult patients. 28 (25.5%) were HIV-1 positive. 8 HIV-infected patients had AIDS. No patient was HIV-2 positive. The physicians were able to make an etiological diagnosis of pneumonia in 50% of the HIV-infected patients and in 52.4% of HIV-negative patients. Streptococcus pneumoniae was responsible for most acute community-acquired pneumonia cases (29.3% for HIV-negative and 25% for HIV-positive patients; no significant difference). The next most common bacterial agent was Mycoplasma pneumoniae (8.8% and 12%, respectively; no significant difference). HIV-positive pneumonia cases were more likely to have microorganisms isolated from blood cultures than HIV-negative pneumonia cases (30% vs. 10%; p = 0.03). The mortality rate did not differ between HIV-positive and HIV-negative cases (7.1% vs. 7.3%). These findings showed a favorable outcome for both groups. The significant difference between the two groups was a higher frequency of bacteremia in HIV-positive patients.