Pulmonary microbiology of HIV positive subjects with community-acquired pneumonia (CAP) with special emphasis on Mycoplasma pneumoniae

Background: A great deal of effort has been devoted to understanding the role of AIDSassociated mycoplasmas in recent years. However, the role of Mycoplasma pneumoniae in HIV disease remains unclear. Methods: We studied 300 adult HIV infected persons (200 with community-acquired pneumonia (CAP) and 100 with no respiratory illness) and 75 HIV uninfected persons with CAP and analysed the prevalence of respiratory pathogens. Results: Prevalence of M. pneumoniae was 17% by induced sputum and 11.3% by throat swab culture in HIV positive subjects. Seroprevalence of anti-M. pneumoniae IgM was 11.7% by ELISA and 14.3% by gelatin microparticle agglutination test. Prevalence of M. pneumoniae among HIV negative cases was relatively low. Streptococcus pneumoniaewas predominant (28%) among subjects with lower respiratory disease, whereas Staphylococcus aureus (15%) was more common among cases with upper respiratory illness. Rales (P=0.001), pharyngeal erythema (P=0.02), cervical adenopathy (P=0.004) and crepitations (P=0.001) showed significance in relation to M. pneumoniae positivity. Statistical significance was observed with regard to total lymphocyte count (P=0.02) and erythrocyte sedimentation rate (P=0.04), and M. pneumoniae positivity. Conclusion: The prevalence of M. pneumoniae in HIV infected subjects was relatively higher than HIV uninfected subjects with respiratory disease.