Bacteremia in hospitalized patients with human immunodeficiency virus: A prospective, cohort study

Background: Bacterial infections complicate the course of patients with human immunodeficiency virus infection. The purpose of this study wa to describe the bacterial pathogens causing blood stream infection, identify the risk factors for the development of blood stream infection and determine the impact of blood stream infection on the outcome of patient infected with human immunodeficiency virus. Method : The incidence, etiology, risk factor and outcome of bacterial blood stream infection were prospectively determined in 1,225 consecutive hospitalizations of adult with human immunodeficiency virus infection. Result : Blood stream infection occurred in 88 hospitalizations (7%); 73 of 89 infections (82%) were community acquired. The most commonly isolated gram-positive organism wa Streptococcus pneumoniae (21); gram-negative, Escherichis coli (14). Blood stream infection wa detected in 8% of African American and 22% of Hispanic compared with 2% of white (P=0.0013). Patient with blood stream infection had higher white blood cell count (median, 6.5 v. 4.9 x 10(9)/L; P=0.0002) and mortality (18% v. 4%; P<0.0001) than patients without infection. Conclusions: In patient with human immunodeficiency virus, blood stream infection is associated with an increased mortality rate. Recognition of the incidence, etiology, and risk factor of blood stream infection in patient with human immunodeficiency virus infection could lead to measure that reduce the increased mortality.