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M9480103.TXT
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1994-08-09
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Document 0103
DOCN M9480103
TI Serious Pseudomonas aeruginosa infection in AIDS.
DT 9410
AU Shepp DH; Tang IT; Ramundo MB; Kaplan MK; Department of Medicine, North
Shore University Hospital-Cornell,; University Medical College,
Manhasset, New York 11030.
SO J Acquir Immune Defic Syndr. 1994 Aug;7(8):823-31. Unique Identifier :
AIDSLINE MED/94293164
AB During a 7-year period, 32 patients with Pseudomonas aeruginosa
infection were identified on an HIV treatment service at a
university-affiliated teaching hospital. The number of cases increased
from 2 in 1986 to 13 in 1992. Affected patients had evidence of advanced
HIV infection. In those treated with antiretroviral therapy, 96% of
infections occurred > 1 year after initial presentation with HIV
disease. Eighteen cases of pneumonia and 14 nonpulmonary (central venous
access device, soft tissue, middle ear-mastoid, corneal, and peritoneal)
infections were seen. Comparison with matched controls identified use of
a central venous access device and administration of aerosolized
pentamidine, corticosteroids, or ganciclovir as risk factors for
infection (odds ratios, 5.3, 6.5, 15.0, and 9.0, respectively; p =
0.004, 0.007, 0.02, and 0.02, respectively). Seventy-five percent of
cases had community onset, but time since last hospital discharge was
significantly shorter in study patients than in controls (mean
difference, -85 days; 95% confidence interval, -24 to -146; p = 0.01).
Among evaluable cases, outcome was fatal (survival < or = 30 days) in 2
of 16 (13%) patients in whom initial antibiotic therapy was appropriate
and 8 of 14 (57%) patients in whom initial therapy was not appropriate
(p = 0.016). Ten recurrent infections were seen in 8 of 21 patients who
survived the initial infection. Median survival after onset of infection
was only 80 days. Pseudomonas aeruginosa infection is an increasingly
frequent, severe complication of advanced HIV disease. Several treatment
and prevention strategies used in the management of advanced HIV disease
are associated with an increased risk of infection.
DE Adult Aged AIDS-Related Opportunistic
Infections/*EPIDEMIOLOGY/MORTALITY
Bacteremia/COMPLICATIONS/EPIDEMIOLOGY/MORTALITY Catheterization,
Central Venous Community-Acquired
Infections/COMPLICATIONS/EPIDEMIOLOGY/ MORTALITY Corneal
Ulcer/COMPLICATIONS/EPIDEMIOLOGY/MORTALITY Cross
Infection/COMPLICATIONS/*EPIDEMIOLOGY/MORTALITY Female Human Male
Middle Age Pneumonia/COMPLICATIONS/EPIDEMIOLOGY/MORTALITY Prospective
Studies Pseudomonas Infections/COMPLICATIONS/*EPIDEMIOLOGY/MORTALITY
Recurrence Retrospective Studies Risk Factors Support, Non-U.S. Gov't
JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).