Nosocomial infections in HIV infected patients. Gruppo HIV e Infezioni Ospedaliere.
OBJECTIVE
To determine the incidence of nosocomial infections (NI) in HIV-infected patients and to analyse some of the associated risk factors.


METHODS
Multicentre prospective study on consecutive HIV-infected patients admitted to 19 Italian acute-care infectious disease wards.


METHODS
All patients admitted during a 1-year period were followed-up for NI until their discharge. Univariate and multivariate analyses were performed for NI risk factors.


RESULTS
As of June 1998 a total of 344 NI occurred in 4330 admissions, with at least one NI in 273 admissions (6.3%). The incidence rate of NI was 3.6 per 1000 patient days [95% confidence interval (CI), 3.2-4.1]. Overall distribution by site was 36.6% bloodstream infections (BSI), 30.5% urinary tract infections, 18.4% pneumonia, 5.2% skin/soft tissue infections, 2.0% surgical wound infections and 7.3% others. Fifty-five out of the 126 BSI were related to a central venous catheter (CVC); the rate of CVC-associated infections was eight infections per 1000 devices. At multivariate analysis, variables independently associated with NI included CD4 T-lymphocyte count < 200 x 10(6)/l [odds ratio (OR), 2.21; 95% CI, 1.35-3.62], Karnofsky Performance Status < 40 (OR, 1.89; 95% CI, 1.28-2.78), therapy with corticosteroids (OR, 1.78; 95% CI, 1.29-2.45), CVC (OR, 3.24; 95% CI, 2.41-4.35), urinary catheter (OR, 6.53; 95% CI, 4.81-8.86) and surgery (OR, 3.13; 95% CI, 1.90-5.15).


CONCLUSIONS
Results suggest that NI occur commonly in HIV-infected patients. As the number of cases of HIV continues to increase, the number of HIV-infected patients requiring hospitalization may also increase. Clinicians need to be aware of the risk factors for NI and must consider these infections in the overall management of HIV-infected, hospitalized patients.
Petrosillo
N
N
Centro di Riferimento AIDS e Servizio di Epidemiologia delle Malattie Infettive, IRCCS L. Spallanzani, Rome, Italy.
Pugliese
G
G
Girardi
E
E
Pallavicini
F
F
Carosi
G
G
Moro
M L
ML
Ippolito
G
G
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D003428:Cross Infection / Q000453:epidemiology; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011446:Prospective Studies