Pseudomonas aeruginosa Bacteremia in Patients Infected with Human Immunodeficiency Virus Type 1 |
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Authors: | F Vidal J Mensa J A Martínez M Almela F Marco J M Gatell C Richart E Soriano M T Jiménez de Anta |
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Institution: | (1) Department of Internal Medicine, Hospital Universitari de Tarragona JOAN XXIII, Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, University Rovira i Virgili, Mallafré Guasch 4, E-43007 Tarragona, Spain e-mail: fvidal@galenics.com, ES;(2) Department of Infectious Diseases, Hospital Clínic, University of Barcelona, Villarroel 170, Barcelona E-08036, Spain, ES;(3) Department of Microbiology, Hospital Clínic, University of Barcelona, Villarroel 170, Barcelona E-08036, Spain, ES |
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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. |
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