Nosocomial bloodstream infection in human immunodeficiency virus-infected patients in Taiwan: descriptive epidemiology and risk factors for mortality.
OBJECTIVE
Nosocomial bloodstream infection (NBSI) is common in patients with human immunodeficiency virus (HIV) infection. This study evaluated the incidence, causative pathogens, and outcome of NBSIs in hospitalized HIV-infected patients at a university hospital in Taiwan.


METHODS
The medical records of all HIV-infected patients who developed NBSIs from June 1994 to June 2003 were retrospectively reviewed. A standardized case record form was used to collect demographic, clinical, laboratory, and microbiologic data.


RESULTS
During the study period, 57 episodes of NBSIs occurred in 51 HIV-infected patients whose median age was 37 years (range, 23 to 60 years). All of the patients were at HIV infection stage C. The incidence of NBSIs was 2.3 per 1000 person-days of hospitalization (41.4 per 1000 discharges). More than three-fourths of the 57 episodes (77.2%) were classified as primary NBSIs. Other infection foci included respiratory tract (6 episodes), urinary tract (3), surgical site (2), and skin (2). Staphylococcus species were the leading pathogens (42.1%). The crude and attributable mortality rates in patients with NBSIs during the study period were 38.6% and 26.1%, respectively. Multivariate analysis using a logistic regression model revealed that shock and hypoalbuminemia at the onset of NBSIs were the 2 factors predictive of mortality.


CONCLUSIONS
NBSIs in hospitalized patients in the late stage of HIV infection were associated with a high attributable mortality rate. Staphylococcus species were the leading pathogen responsible for NBSIs. Presentations of shock and hypoalbuminemia were predictive of mortality.
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100, Taiwan.
Jann-Tay
JT
Wang
Wang-Huei
WH
Sheng
Mao-Yuan
MY
Chen
Chi-Tai
CT
Fang
Szu-Min
SM
Hsieh
Po-Ren
PR
Hsueh
Chien-Ching
CC
Hung
Shan-Chwen
SC
Chang
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology