BACTEREMIA IN HOSPITALIZED-PATIENTS INFECTED WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS - A CASE-CONTROL STUDY OF RISK-FACTORS AND OUTCOME

We reviewed all episodes of nonmycobacterial bacteremias in human immu nodeficiency virus (HIV)-infected patients from 1990 to 1991 to determ ine the incidence, risk factors, and outcome. Forty-five patients had a total of 63 episodes of bacteremia (9% of 689 HIV-related hospitaliz ations). In this cohort, the median CD4(+) lymphocyte count was 17 cel ls/mm(3), 71% had AIDS, and 78% were homosexual men. The most frequent ly isolated bacteria were Staphylococcus aureus (25%) and coagulase-ne gative staphylococci (22%). The most common site of infection was intr avenous catheter-related, accounting for 35% of the bacteremias. Compa red to HIV-infected, nonbacteremic controls, patients with bacteremia detected at admission were more likely to have an indwelling intraveno us 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 sig nificant difference in the in-hospital mortality rates in bacteremic p atients with or without HIV infection. Seventeen patients had more tha n one episode of bacteremia (71% had recurrence with the same organism ). We conclude that bacteremia is a significant problem in HIV-infecte d persons with low CD4(+) lymphocyte counts, often related to the pres ence of an intravenous catheter; recurrence is common. In addition, HI V infection does not appear to increase the mortality rate for bactere mia.