HAEMOPHILUS-INFLUENZAE TYPE-B BACTEREMIA IN ADULTS WITH AIDS AND AT RISK FOR AIDS

PURPOSE: Our objective was to determine the number of cases of Haemophilus influenzae type b bacteremia in patients with and at risk for acquired immunodeficiency syndrome (AIDS) from January 1983 to June 1991 at a municipal hospital in Bronx, New York. PATIENTS AND METHODS: We reviewed blood culture records of adult patients admitted to North Central Bronx Hospital from January 1983 to June 1991 to identify cases of bacteremic H. influenzae type b disease. The hospital charts and admission chest radiographs of bacteremic patients were then reviewed. RESULTS: Ten of 15 cases of adult H. influenzae type b bacteremia occurred in patients with AIDS or who were at risk for AIDS. Seven had AIDS at presentation. Nine were active or former intravenous drug users (IVDUs). All 10 cases were associated with a respiratory source, and five of the 10 patients also had H. influenzae type b isolated from sputum. All H. influenzae type b strains were negative for beta-lactamase. CONCLUSIONS: Human immunodeficiency virus-positive IVDUs may be at increased risk for bacteremic H. influenzae type b infections. Empiric antibiotic regimens for community-acquired pneumonia in these patients should include appropriate antibiotics for the treatment of H. influenzae type b. In addition, these patients may be candidates for conjugate H. influenzae type b vaccine trials.