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

C. J. Fichtenbaum, W. C. Dunagan, W. G. Powderly

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53 Scopus citations

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 taking 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.

Original languageEnglish
Pages (from-to)51-57
Number of pages7
JournalJournal of Acquired Immune Deficiency Syndromes
Volume8
Issue number1
StatePublished - Jan 1 1995

Keywords

  • Bacteremia
  • Bacterial infections
  • Human immunodeficiency virus (HIV) infection
  • Intravenous catheters
  • Sepsis

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