Pseudomonas aeruginosa bacteremia in patients infected with human immunodeficiency virus type 1

Eur J Clin Microbiol Infect Dis. 1999 Jul;18(7):473-7. doi: 10.1007/s100960050326.

Abstract

A prospective analysis of 43 episodes of Pseudomonas aeruginosa bacteremia in HIV-1-infected subjects was performed and the results compared with the incidence and outcome of Pseudomonas aeruginosa bacteremia in other high-risk patients, such as transplant recipients, leukemia patients, or patients hospitalized in the intensive care unit. The incidence of bacteremia/fungemia as a whole and of gram-negative and Pseudomonas aeruginosa bacteremia in particular was greater in HIV-1-infected subjects than in the unselected general population admitted. In contrast, the incidence of Pseudomonas aeruginosa bacteremia in HIV-1-infected patients did not differ from that in patients with other high-risk conditions. In patients with HIV-1 infection, independent risk factors for presenting Pseudomonas aeruginosa bacteremia were nosocomial origin (OR, 2.7; 95% CI, 1.3-5.7), neutropenia (OR, 2.7; 95% CI, 1.07-6.8), previous treatment with cephalosporins (OR, 3.6; 95% CI, 1.1-11.6), and a CD4+ cell count lower than 50 cells/mm3 (OR, 3.1; 95% CI, 1.7-8.6). Primary bacteremia and pneumonia were the most common forms of presentation. Fourteen (33%) patients died as a consequence of the bacteremia. The presence of severe sepsis (OR, 17.5; 95% CI, 3.2-68) and the institution of inappropriate definitive antibiotic therapy (OR, 2.7; 95% CI, 1.1-13) were independently associated with a poor outcome. One year after the development of bacteremia, only eight (19%) patients remained alive.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AIDS-Related Opportunistic Infections / epidemiology
  • AIDS-Related Opportunistic Infections / microbiology*
  • AIDS-Related Opportunistic Infections / physiopathology
  • Adolescent
  • Adult
  • Aged
  • Bacteremia / complications*
  • Bacteremia / epidemiology
  • Bacteremia / physiopathology
  • Child
  • Cohort Studies
  • Female
  • HIV-1*
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Pseudomonas Infections / complications*
  • Pseudomonas Infections / epidemiology
  • Pseudomonas Infections / physiopathology
  • Pseudomonas aeruginosa
  • Risk Factors
  • Spain / epidemiology