Nosocomial infections in the human immunodeficiency virus-infected patient: a two-year survey.
BACKGROUND
Because HIV-infected patients are often hospitalized and have major defects in host defenses, we surveyed all HIV-infected patients admitted to our institution to determine incidence of infections and to risk factors for nosocomial infections.


METHODS
All patients admitted during a 2-year period were monitored for nosocomial infections until their discharge, death, or transfer. Categoric data were evaluated with the Fisher Exact Test or chi 2 test. Continuous variables were compared with the t test or Mann-Whitney test.


RESULTS
Ten percent of patient admissions (22/210) resulted in 32 nosocomial infections. Risk factors included longer hospitalization (29.8 vs 10.8 days), urinary catheters (35% vs 11%), gastrointestinal procedures (23% vs 3%), and vascular access (41% vs 19%). The most frequent etiologic agents were gram-positive organisms, primarily Staphylococcus species (44% [14/32]).


CONCLUSIONS
Nosocomial infection rates for the HIV-infected patient were higher than the overall infection rate. Agents with broad-spectrum activity against gram-positive organisms, such as vancomycin, should be considered during the wait for culture results.
Goetz
A M
AM
VA Medical Center, Pittsburgh, PA 15240.
Squier
C
C
Wagener
M M
MM
Muder
R R
RR
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000453:epidemiology; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000009:adverse effects; D003428:Cross Infection / Q000453:epidemiology* / Q000401:mortality; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology*; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010414:Pennsylvania / Q000453:epidemiology; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors