title: Nosocomial bloodstream infections among human immunodeficiency virus-infected patients: incidence and risk factors.
abstract: 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.
authors.affiliation: Istituto Nazionale per le Malattie Infettive "L. Spallanzani," Istituto di Ricovero e Cura a Carattere Scientifico, 00149 Rome, Italy. petrosillo@inmi.it
authors.forename: Nicola
authors.initials: N
authors.lastname: Petrosillo
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Viale
authors.forename: Emanuele
authors.initials: E
authors.lastname: Nicastri
authors.forename: Claudio
authors.initials: C
authors.lastname: Arici
authors.forename: Enrico
authors.initials: E
authors.lastname: Bombana
authors.forename: Alberto
authors.initials: A
authors.lastname: Casella
authors.forename: Francesco
authors.initials: F
authors.lastname: Cristini
authors.forename: Michele
authors.initials: M
authors.lastname: De Gennaro
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Dodi
authors.forename: Andrea
authors.initials: A
authors.lastname: Gabbuti
authors.forename: Gianni
authors.initials: G
authors.lastname: Gattuso
authors.forename: Laura
authors.initials: L
authors.lastname: Irato
authors.forename: Paolo
authors.initials: P
authors.lastname: Maggi
authors.forename: Federico
authors.initials: F
authors.lastname: Pallavicini
authors.forename: Angelo
authors.initials: A
authors.lastname: Pan
authors.forename: Mario
authors.initials: M
authors.lastname: Pantaleoni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ippolito
mesh_terms: 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