SERIOUS PSEUDOMONAS-AERUGINOSA INFECTIONS IN PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS - A CASE-CONTROL STUDY

We conducted a case-control study to determine the incidence and clini cal features of and risk factors for Pseudomonas aeruginosa infections in patients infected with human immunodeficiency virus (HIV). Twenty- five patients who had 37 episodes of P. aeruginosa infection from 1990 through 1992 were identified. Most of the patients (92%) were homosex ual men with low CD4+ lymphocyte counts and a history of AIDS. The ann ual incidence rates of P. aeruginosa infection were 3.5% (1990), 6.3% (1991), and 8.7% (1992). Most infections were community-acquired (68%) and involved the respiratory tract (73%). Patients were more likely t han HIV-infected controls to have AIDS and had more AIDS-defining oppo rtunistic illnesses. The overall mortality was 36%. Recurrent episodes were common (39%). We conclude that P. aeruginosa infections may be a n increasing problem in patients with extremely advanced HIV infection . Clinicians should consider including antibiotics with activity again st P. aeruginosa in the empirical treatment for suspected bacterial in fection in patients with advanced HIV infection.