Nosocomial bloodstream infections among human immunodeficiency virus-infected patients: incidence and risk factors.
To assess the incidence of nosocomial bloodstream infections (NBSIs) in human immunodeficiency virus (HIV)-infected patients, and to analyze the main associated risk factors, we performed a 1-year multicenter prospective study of patients with advanced HIV infection who were consecutively admitted to 17 Italian infectious diseases wards. As of May 1999, a total of 65 NBSIs (4.7%) occurred in 1379 admissions, for an incidence of 2.45 NBSIs per 1000 patient-days. Twenty-nine NBSIs were catheter-related bloodstream infections, with a rate of 9.6 central venous catheter-associated infections per 1000 device-days. Multivariate analysis indicated that variables independently associated with NBSIs included active injection drug use, a Karnofsky Performance Status score of <40, presence of a central venous catheter, and length of hospital stay. Mortality rates were 24.6% and 7.2% among patients with and without NBSIs, respectively (P<.00001). In the era of highly active antiretroviral therapy, NBSIs continue to occur frequently and remain severe and life-threatening manifestations.
Petrosillo
Nicola
N
Istituto Nazionale per le Malattie Infettive "L. Spallanzani," Istituto di Ricovero e Cura a Carattere Scientifico, 00149 Rome, Italy. petrosillo@inmi.it
Viale
Pierluigi
P
Nicastri
Emanuele
E
Arici
Claudio
C
Bombana
Enrico
E
Casella
Alberto
A
Cristini
Francesco
F
De Gennaro
Michele
M
Dodi
Ferdinando
F
Gabbuti
Andrea
A
Gattuso
Gianni
G
Irato
Laura
L
Maggi
Paolo
P
Pallavicini
Federico
F
Pan
Angelo
A
Pantaleoni
Mario
M
Ippolito
Giuseppe
G
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology