Nosocomial infections in HIV infected patients

Nicola Petrosillo, Gina Pugliese, Enrico Girardi, Federico Pallavicini, Giampiero Carosi, Maria Luisa Moro, Giuseppe Ippolito

Research output: Contribution to journalArticle

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Abstract

Objectives: To determine the incidence of nosocomial infections (NI) in HIV-infected patients and to analyse some of the associated risk factors. Design and setting: Multicentre prospective study on consecutive HIV-infected patients admitted to 19 Italian acute-care infectious disease wards. Methods: All patients admitted during a 1-year period were followed-up for NI until their discharge. Univariate and multivariate analyses were performed for NI risk factors. Results: As of June 1998 a total of 344 NI occurred in 4330 admissions, with at least one NI in 273 admissions (6.3%). The incidence rate of NI was 3.6 per 1000 patient days [95% confidence interval (CI), 3.2-4.1]. Overall distribution by site was 36.6% bloodstream infections (BSI), 30.5% urinary tract infections, 18.4% pneumonia, 5.2% skin/soft tissue infections, 2.0% surgical wound infections and 7.3% others. Fifty-five out of the 126 BSI were related to a central venous catheter (CVC); the rate of CVC-associated infections was eight infections per 1000 devices. At multivariate analysis, variables independently associated with NI included CD4 T-lymphocyte count <200 x 106/l [odds ratio (OR), 2.21; 95% CI, 1.35-3.62], Karnofsky Performance Status <40 (OR, 1.89; 95% CI, 1.28-2.78), therapy with corticosteroids (OR, 1.78; 95% CI, 1.29-2.45), CVC (OR, 3.24; 95% CI, 2.41-4.35), urinary catheter (OR, 6.53; 95% CI, 4.81-8.86) and surgery (OR, 3.13; 95% CI, 1.30-5.15). Conclusions: Results suggest that NI occur commonly in HIV-infected patients. As the number of cases of HIV continues to increase, the number of HIV-infected patients requiring hospitalization may also increase. Clinicians need to be aware of the risk factors for NI and must consider these infections in the overall management of HIV-infected, hospitalized patients.

Original languageEnglish
Pages (from-to)599-605
Number of pages7
JournalAIDS (London, England)
Volume13
Issue number5
DOIs
Publication statusPublished - 1999

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Cross Infection
HIV
Confidence Intervals
Odds Ratio
Central Venous Catheters
Infection
Multivariate Analysis
Karnofsky Performance Status
Surgical Wound Infection
Catheter-Related Infections
Urinary Catheters
Soft Tissue Infections
Incidence
CD4 Lymphocyte Count
Urinary Tract Infections
Multicenter Studies
Communicable Diseases
Pneumonia
Adrenal Cortex Hormones
Hospitalization

Keywords

  • Epidemiology
  • Nosocomial infections
  • Risk factors

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Nosocomial infections in HIV infected patients. / Petrosillo, Nicola; Pugliese, Gina; Girardi, Enrico; Pallavicini, Federico; Carosi, Giampiero; Moro, Maria Luisa; Ippolito, Giuseppe.

In: AIDS (London, England), Vol. 13, No. 5, 1999, p. 599-605.

Research output: Contribution to journalArticle

Petrosillo, Nicola ; Pugliese, Gina ; Girardi, Enrico ; Pallavicini, Federico ; Carosi, Giampiero ; Moro, Maria Luisa ; Ippolito, Giuseppe. / Nosocomial infections in HIV infected patients. In: AIDS (London, England). 1999 ; Vol. 13, No. 5. pp. 599-605.
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abstract = "Objectives: To determine the incidence of nosocomial infections (NI) in HIV-infected patients and to analyse some of the associated risk factors. Design and setting: Multicentre prospective study on consecutive HIV-infected patients admitted to 19 Italian acute-care infectious disease wards. Methods: All patients admitted during a 1-year period were followed-up for NI until their discharge. Univariate and multivariate analyses were performed for NI risk factors. Results: As of June 1998 a total of 344 NI occurred in 4330 admissions, with at least one NI in 273 admissions (6.3{\%}). The incidence rate of NI was 3.6 per 1000 patient days [95{\%} confidence interval (CI), 3.2-4.1]. Overall distribution by site was 36.6{\%} bloodstream infections (BSI), 30.5{\%} urinary tract infections, 18.4{\%} pneumonia, 5.2{\%} skin/soft tissue infections, 2.0{\%} surgical wound infections and 7.3{\%} others. Fifty-five out of the 126 BSI were related to a central venous catheter (CVC); the rate of CVC-associated infections was eight infections per 1000 devices. At multivariate analysis, variables independently associated with NI included CD4 T-lymphocyte count <200 x 106/l [odds ratio (OR), 2.21; 95{\%} CI, 1.35-3.62], Karnofsky Performance Status <40 (OR, 1.89; 95{\%} CI, 1.28-2.78), therapy with corticosteroids (OR, 1.78; 95{\%} CI, 1.29-2.45), CVC (OR, 3.24; 95{\%} CI, 2.41-4.35), urinary catheter (OR, 6.53; 95{\%} CI, 4.81-8.86) and surgery (OR, 3.13; 95{\%} CI, 1.30-5.15). Conclusions: Results suggest that NI occur commonly in HIV-infected patients. As the number of cases of HIV continues to increase, the number of HIV-infected patients requiring hospitalization may also increase. Clinicians need to be aware of the risk factors for NI and must consider these infections in the overall management of HIV-infected, hospitalized patients.",
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AU - Petrosillo, Nicola

AU - Pugliese, Gina

AU - Girardi, Enrico

AU - Pallavicini, Federico

AU - Carosi, Giampiero

AU - Moro, Maria Luisa

AU - Ippolito, Giuseppe

PY - 1999

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N2 - Objectives: To determine the incidence of nosocomial infections (NI) in HIV-infected patients and to analyse some of the associated risk factors. Design and setting: Multicentre prospective study on consecutive HIV-infected patients admitted to 19 Italian acute-care infectious disease wards. Methods: All patients admitted during a 1-year period were followed-up for NI until their discharge. Univariate and multivariate analyses were performed for NI risk factors. Results: As of June 1998 a total of 344 NI occurred in 4330 admissions, with at least one NI in 273 admissions (6.3%). The incidence rate of NI was 3.6 per 1000 patient days [95% confidence interval (CI), 3.2-4.1]. Overall distribution by site was 36.6% bloodstream infections (BSI), 30.5% urinary tract infections, 18.4% pneumonia, 5.2% skin/soft tissue infections, 2.0% surgical wound infections and 7.3% others. Fifty-five out of the 126 BSI were related to a central venous catheter (CVC); the rate of CVC-associated infections was eight infections per 1000 devices. At multivariate analysis, variables independently associated with NI included CD4 T-lymphocyte count <200 x 106/l [odds ratio (OR), 2.21; 95% CI, 1.35-3.62], Karnofsky Performance Status <40 (OR, 1.89; 95% CI, 1.28-2.78), therapy with corticosteroids (OR, 1.78; 95% CI, 1.29-2.45), CVC (OR, 3.24; 95% CI, 2.41-4.35), urinary catheter (OR, 6.53; 95% CI, 4.81-8.86) and surgery (OR, 3.13; 95% CI, 1.30-5.15). Conclusions: Results suggest that NI occur commonly in HIV-infected patients. As the number of cases of HIV continues to increase, the number of HIV-infected patients requiring hospitalization may also increase. Clinicians need to be aware of the risk factors for NI and must consider these infections in the overall management of HIV-infected, hospitalized patients.

AB - Objectives: To determine the incidence of nosocomial infections (NI) in HIV-infected patients and to analyse some of the associated risk factors. Design and setting: Multicentre prospective study on consecutive HIV-infected patients admitted to 19 Italian acute-care infectious disease wards. Methods: All patients admitted during a 1-year period were followed-up for NI until their discharge. Univariate and multivariate analyses were performed for NI risk factors. Results: As of June 1998 a total of 344 NI occurred in 4330 admissions, with at least one NI in 273 admissions (6.3%). The incidence rate of NI was 3.6 per 1000 patient days [95% confidence interval (CI), 3.2-4.1]. Overall distribution by site was 36.6% bloodstream infections (BSI), 30.5% urinary tract infections, 18.4% pneumonia, 5.2% skin/soft tissue infections, 2.0% surgical wound infections and 7.3% others. Fifty-five out of the 126 BSI were related to a central venous catheter (CVC); the rate of CVC-associated infections was eight infections per 1000 devices. At multivariate analysis, variables independently associated with NI included CD4 T-lymphocyte count <200 x 106/l [odds ratio (OR), 2.21; 95% CI, 1.35-3.62], Karnofsky Performance Status <40 (OR, 1.89; 95% CI, 1.28-2.78), therapy with corticosteroids (OR, 1.78; 95% CI, 1.29-2.45), CVC (OR, 3.24; 95% CI, 2.41-4.35), urinary catheter (OR, 6.53; 95% CI, 4.81-8.86) and surgery (OR, 3.13; 95% CI, 1.30-5.15). Conclusions: Results suggest that NI occur commonly in HIV-infected patients. As the number of cases of HIV continues to increase, the number of HIV-infected patients requiring hospitalization may also increase. Clinicians need to be aware of the risk factors for NI and must consider these infections in the overall management of HIV-infected, hospitalized patients.

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