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

## TL;DR

This paper discusses how sepsis from bloodstream infections is a major cause of death in people with advanced HIV disease, especially due to antibiotic-resistant bacteria.

## Contribution

The paper highlights the growing risk of antimicrobial resistance in sepsis cases among patients with advanced HIV disease.

## Key findings

- Sepsis from bloodstream infections is a leading cause of mortality in advanced HIV disease patients.
- Antimicrobial-resistant organisms are increasingly causing bloodstream infections in this population.
- More research is needed to improve interventions for sepsis in 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, 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.