Franceschini, E;
Santoro, A;
Menozzi, M;
Bacca, E;
Venturelli, C;
Zona, S;
Bedini, A;
... Mussini, C; + view all
(2020)
Epidemiology and Outcomes of Bloodstream Infections in HIV-Patients during a 13-Year Period.
Microorganisms
, 8
(8)
, Article 1210. 10.3390/microorganisms8081210.
Preview |
Text
Cozzi-Lepri_Epidemiology and Outcomes of Bloodstream Infections in HIV-Patients during a 13-Year Period_VoR.pdf - Published Version Download (1MB) | Preview |
Abstract
No data on antibiotic resistance in bloodstream infection (BSI) in people living with HIV (PLWH) exist. The objective of this study was to describe BSI epidemiology in PLWH focusing on multidrug resistant (MDR) organisms. A retrospective, single-center, observational study was conducted including all positive blood isolates in PLWH from 2004 to 2017. Univariable and multivariable GEE models using binomial distribution family were created to evaluate the association between MDR and mortality risk. In total, 263 episodes (299 isolates) from 164 patients were analyzed; 126 (48%) BSI were community-acquired, 137 (52%) hospital-acquired. At diagnosis, 34.7% of the patients had virological failure, median CD4 count was 207/μL. Thirty- and 90-day mortality rates were 24.2% and 32.4%, respectively. Thirty- and 90-day mortality rates for MDR isolates were 33.3% and 46.9%, respectively (p < 0.05). Enterobacteriaceae were the most prevalent microorganisms (29.8%), followed by Coagulase-negative staphylococci (21.4%), and S. aureus (12.7%). In BSI due to MDR organisms, carbapenem-resistant K. pneumoniae and methicillin-resistant S. aureus were associated with mortality after adjustment for age, although this correlation was not confirmed after further adjustment for CD4 < 200/μL. In conclusion, BSI in PLWH is still a major problem in the combination antiretroviral treatment era and it is related to a poor viro-immunological status, posing the question of whether it should be considered as an AIDS-defining event.
| Type: | Article |
|---|---|
| Title: | Epidemiology and Outcomes of Bloodstream Infections in HIV-Patients during a 13-Year Period |
| Location: | Switzerland |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3390/microorganisms8081210 |
| Publisher version: | https://doi.org/10.3390/microorganisms8081210 |
| Language: | English |
| Additional information: | © 2020 by the Authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | HIV, bloodstream infections, multidrug resistant |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10108312 |
Archive Staff Only
 |
View Item |
