title: Nosocomial infections in human immunodeficiency virus-infected patients in a long-term-care setting.
abstract: To our knowledge, the epidemiology of hospital-acquired infections in human immunodeficiency virus (HIV)-infected patients during long-term care has not been reported. For 13 months, we observed HIV-infected patients (50 men and 15 women) in a dedicated 21-bed unit in a long-term-care facility to determine the rate of nosocomial infections. The mean age of the patients was 39 years (range, 22-78 years); 74% of the patients had CD4 cell counts of < 200/mm3. There was a total of 152 infections (24 infections per 1,000 long-term-care days). The factors associated with the occurrence of a nosocomial infection were low CD4 cell counts, poor functional status, and longer duration of stays at the facility. The three most common infections were Clostridium difficile-associated diarrhea, primary bacteremia, and urinary tract infection. Eighteen hospital-manifested opportunistic infections occurred. More than 50% of the cases of bacteremia were due to multidrug-resistant organisms. Nosocomial infections occur commonly in HIV-infected patients in long-term care and thus are important considerations in patient management.
authors.affiliation: Department of Internal Medicine, Cook County Hospital and Rush Medical College, Chicago, Illinois 60612, USA.
authors.forename: P L
authors.initials: PL
authors.lastname: DeMarais
authors.forename: J
authors.initials: J
authors.lastname: Gertzen
authors.forename: R A
authors.initials: RA
authors.lastname: Weinstein
mesh_terms: D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000150:complications / Q000635:transmission*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D013997:Time Factors