Nosocomial bacterial pneumonia in human immunodeficiency virus infected subjects: incidence, risk factors and outcome

The presented study examined the incidence, risk factors and outcome of nos ocomial bacterial pneumonia (NBP) in human immunodeficiency virus (HIV)infe cted subjects. Forty-two cases of NBP were ascertained by a 5-yr prospectiv e surveillance and were matched to 84 controls. NBP incidence was 10.8 per 10,000 hospital patient-days. In particular, the incidence of NBP was 13.9 per 10,000 patient-days in the period 1994-1996 and 5.6 per 10,000 patient- days in the period 1997-1998 (p=0.01). By using regression analysis, predictors for developing NBP were an increas ing value of Acute Physiology and Chronic Health Evaluation (APACHE) III sc ore (p<0.01) and the presence of acquired immune deficiency syndrome (AIDS) -related central nervous system (CNS) diseases (p=0.01). The additional hos pital stay attributable to NBP was 15 days. The attributable mortality rate ,ras estimated to be 29%. Nosocomial bacterial pneumonia is more common in patients with advanced hum an immunodeficiency virus infection, high Acute Physiology and Chronic Heal th Evaluation III score and central nervous system diseases. Although the i ncidence of nosocomial bacterial pneumonia, as well of other opportunistic infections, decreased considerably in the era of highly active antiretrovir al therapy, it still represents an important cause of mortality.