RECOVERY OF PSEUDOMONAS-AERUGINOSA IN RESPIRATORY SPECIMENS FROM HIV-POSITIVE PATIENTS BEING EVALUATED FOR PNEUMOCYSTIS PNEUMONIA

Background - Despite the immune suppression, frequent hospital admissi ons, and many intercurrent illnesses associated with HIV infection, Ps eudomonas aeruginosa has been cited relatively infrequently as a respi ratory pathogen in HIV positive patients. Methods - The microbiologica l isolates, medical records, radiographic reports, and laboratory data from 224 patients undergoing sputum induction and/or bronchoalveolar lavage for evaluation of respiratory symptoms suspicious for Pneumocys tis carinii pneumonia (PCP) from 1989 to 1992 were reviewed retrospect ively. Results - An increasing number of respiratory isolates with Pse udomonas aeruginosa was found over this time period. Eighteen of the 2 24 patients were identified in whom P aeruginosa was recovered on at l east one occasion. These patients were more likely to have a history o f smoking and prior PCP than those in whom Pseudomonas was not recover ed. Mean CD4 counts were also significantly lower in these patients. C onclusions - Pseudomonas aeruginosa may be recovered from a substantia l number of respiratory isolates from HIV positive patients suspected of having PCP. The prevalence of this phenomenon may be increasing.