Bacteremia in hospitalized patients infected with the human immunodeficiency virus: a case-control study of risk factors and outcome

J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Jan 1;8(1):51-7.

Abstract

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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Bacteremia / epidemiology
  • Bacteremia / etiology*
  • Bacterial Infections / epidemiology
  • Bacterial Infections / etiology*
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / immunology
  • Case-Control Studies
  • Catheterization, Central Venous / adverse effects
  • Cohort Studies
  • Female
  • HIV Infections / complications*
  • HIV Infections / immunology
  • HIV-1*
  • Hospitalization*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Missouri / epidemiology
  • Recurrence
  • Risk Factors
  • Survival Rate
  • Treatment Outcome