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1996-03-04
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Document 0745
DOCN M9640745
TI Bacteremia in hospitalized patients infected with the human
immunodeficiency virus: a case-control study of risk factors and
outcome.
DT 9604
AU Fichtenbaum CJ; Dunagan WC; Powderly WG; Department of Internal
Medicine, Washington University School of; Medicine, St. Louis, Missouri
63110, USA.
SO J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jan 1;8(1):51-7. Unique
Identifier : AIDSLINE MED/96142200
AB We reviewed all episodes of nonmycobacterial bacteremias in human
immunodeficiency virus (HIV)-infected patients from 1990 to 1991 to
determine the incidence, risk factors, and outcome. Forty-five patients
had a total of 63 episodes of bacteremia (9% of 689 HIV-related
hospitalizations). In this cohort, the median CD4+ lymphocyte count was
17 cells/mm3, 71% had AIDS, and 78% were homosexual men. The most
frequently isolated bacteria were Staphylococcus aureus (25%) and
coagulase-negative staphylococci (22%). The most common site of
infection was intravenous catheter-related, accounting for 35% of the
bacteremias. Compared to HIV-infected, nonbacteremic controls, patients
with bacteremia detected at admission were more likely to have an
indwelling intravenous catheter (p = 0.003) and less likely to be likely
zidovudine (p = 0.04). The overall in-hospital mortality rate was 24%.
There was no significant difference in the in-hospital mortality rates
in bacteremic patients with or without HIV infection. Seventeen patients
had more than one episode of bacteremia (71% had recurrence with the
same organism). We conclude that bacteremia is a significant problem in
HIV-infected persons with low CD4+ lymphocyte counts, often related to
the presence of an intravenous catheter; recurrence is common. In
addition, HIV infection does not appear to increase the mortality rate
for bacteremia.
DE Adult Aged Bacteremia/EPIDEMIOLOGY/*ETIOLOGY Bacterial
Infections/EPIDEMIOLOGY/*ETIOLOGY Case-Control Studies
Catheterization, Central Venous/ADVERSE EFFECTS Cohort Studies CD4
Lymphocyte Count CD4-Positive T-Lymphocytes/IMMUNOLOGY Female
*Hospitalization Human HIV Infections/*COMPLICATIONS/IMMUNOLOGY
*HIV-1 Incidence Male Middle Age Missouri/EPIDEMIOLOGY Recurrence
Risk Factors Support, U.S. Gov't, P.H.S. Survival Rate Treatment
Outcome JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).