mGem: Sepsis and antimicrobial resistance in the context of advanced HIV disease

ABSTRACT Sepsis triggered by bloodstream infections (BSI) is a significant driver of HIV-related mortality, particularly among in-patients with advanced HIV disease (AHD). Currently, the incidence, etiology, and outcomes of BSI in this population are poorly defined. We review the existing evidence,...

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Main Authors: Rachel M. Wake, Nelesh P. Govender
Format: Article
Language:English
Published: American Society for Microbiology 2025-05-01
Series:mBio
Subjects:
Online Access:https://journals.asm.org/doi/10.1128/mbio.00769-24
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author Rachel M. Wake
Nelesh P. Govender
author_facet Rachel M. Wake
Nelesh P. Govender
author_sort Rachel M. Wake
collection DOAJ
description ABSTRACT Sepsis triggered by bloodstream infections (BSI) is a significant driver of HIV-related mortality, particularly among in-patients with advanced HIV disease (AHD). Currently, the incidence, etiology, and outcomes of BSI in this population are poorly defined. We review the existing evidence, which shows an increased risk of BSI, particularly with antimicrobial-resistant (AMR) organisms, and higher BSI-associated mortality in patients with AHD. Causative bacterial and fungal pathogens are often unknown, but when identified, limited data show etiology has shifted probably owing to increasing coverage of antiretroviral treatment, antimicrobial prophylaxis, and rising global AMR trends. Further research is crucial to design and refine interventions before, during, and after hospital admission to reduce sepsis-related mortality in patients with AHD.
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spelling doaj-art-22ff879a850d441bbffe8b41d5ff0e9a2025-08-20T02:24:54ZengAmerican Society for MicrobiologymBio2150-75112025-05-0116510.1128/mbio.00769-24mGem: Sepsis and antimicrobial resistance in the context of advanced HIV diseaseRachel M. Wake0Nelesh P. Govender1Wits Mycology Division, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South AfricaWits Mycology Division, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South AfricaABSTRACT Sepsis triggered by bloodstream infections (BSI) is a significant driver of HIV-related mortality, particularly among in-patients with advanced HIV disease (AHD). Currently, the incidence, etiology, and outcomes of BSI in this population are poorly defined. We review the existing evidence, which shows an increased risk of BSI, particularly with antimicrobial-resistant (AMR) organisms, and higher BSI-associated mortality in patients with AHD. Causative bacterial and fungal pathogens are often unknown, but when identified, limited data show etiology has shifted probably owing to increasing coverage of antiretroviral treatment, antimicrobial prophylaxis, and rising global AMR trends. Further research is crucial to design and refine interventions before, during, and after hospital admission to reduce sepsis-related mortality in patients with AHD.https://journals.asm.org/doi/10.1128/mbio.00769-24human immunodeficiency virusAIDSsepsisbloodstream infectionsantimicrobial resistance
spellingShingle Rachel M. Wake
Nelesh P. Govender
mGem: Sepsis and antimicrobial resistance in the context of advanced HIV disease
mBio
human immunodeficiency virus
AIDS
sepsis
bloodstream infections
antimicrobial resistance
title mGem: Sepsis and antimicrobial resistance in the context of advanced HIV disease
title_full mGem: Sepsis and antimicrobial resistance in the context of advanced HIV disease
title_fullStr mGem: Sepsis and antimicrobial resistance in the context of advanced HIV disease
title_full_unstemmed mGem: Sepsis and antimicrobial resistance in the context of advanced HIV disease
title_short mGem: Sepsis and antimicrobial resistance in the context of advanced HIV disease
title_sort mgem sepsis and antimicrobial resistance in the context of advanced hiv disease
topic human immunodeficiency virus
AIDS
sepsis
bloodstream infections
antimicrobial resistance
url https://journals.asm.org/doi/10.1128/mbio.00769-24
work_keys_str_mv AT rachelmwake mgemsepsisandantimicrobialresistanceinthecontextofadvancedhivdisease
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