Epidemiology and Outcomes of Bloodstream Infections in HIV-Patients during a 13-Year Period
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Patient Characteristics | Total (263 Obs) | Non MDR Isolate (169 Obs) | MDR Isolate (94 Obs) | p Value |
---|---|---|---|---|
Age, median (IQR) | 46 (40–52) | 46 (41–52) | 45 (40–52) | 0.625 |
Male sex, n (%) | 175 (66.5) | 114 (67) | 61 (65) | 0.673 |
Year of event, n (%) | 0.188 | |||
Before 2008 | 105 (40) | 62 (36.7) | 43 (45.7) | |
2009–2013 | 94 (35.7) | 67 (39.6) | 27 (28.7) | |
After 2014 | 64 (24.3) | 40 (23.7) | 24 (25.5) | |
Hospital acquired, n (%) | 137 (52) | 71 (42) | 66 (70) | <0.001 |
Years of HIV *, median (IQR) | 14 (7–22) | 15 (8–23) | 11 (4–19) | 0.021 |
Years of cART **, median (IQR) | 5 (0–10) | 5 (0–10) | 5 (0–9) | 0.944 |
CD4/CD8 ratio ***, median (IQR) | 0.38 (0.13–0.64) | 0.41 (0.14–0.66) | 0.24 (0.10–0.60) | 0.133 |
CD4 count ***, cell/μL, median (IQR) | 207 (73–385) | 216 (84–396) | 186 (45–344) | 0.356 |
CD4 count < 200/μL at event ***, n (%) | 83 (47.4) | 52 (45) | 31 (52) | 0.417 |
HIV RNA > 100.000 copies/mL at event ***, n (%) | 23 (13.3) | 12 (10.8) | 11 (17.7) | 0.198 |
HIV RNA > 10.000 copies/mL at event ***, n (%) | 44 (25.4) | 28 (25.2) | 16 (25.8) | 0.933 |
HIV RNA < 200 copies/mL at event ***, n (%) | 113 (65.3) | 75 (67) | 38 (61) | 0.406 |
Type of isolate, n (%) | 0.061 | |||
Gram negative | 119 (45.2) | 82 (48.5) | 37 (49.4) | |
Gram positive | 139 (52.8) | 82 (48.5) | 57 (60.6) | |
Fungi | 5 (2) | 5 (3) | 0 (0) | |
Death, n (%) | 83 (31.6) | 41 (24.3) | 42 (44.7) | <0.001 |
Gram negative | 39 (32.8) | 20 (24.4) | 19 (51.4) | 0.004 |
Gram positive | 43 (30.9) | 20 (24.4) | 23 (40.4) | 0.045 |
Fungi | 1 (20) | 1 (20) | 0 (0) | - |
Polymicrobial, n (%) | 24 (9.1) | 15 (8.9) | 9 (9.6) | 0.854 |
Central venous associated bacteremia, n (%) | 72 (27.4) | 34 (20.1) | 38 (40.4) | <0.001 |
Gram negative | 26 (36.1) | 14 (41.2) | 12 (31.6) | 0.183 |
Gram positive | 44 (61.1) | 18 (52.9) | 26 (68.4) | |
Fungi | 2 (2.8) | 2 (5.9) | 0 (0) | |
ICU | 9 (40.9) | 5 (14.7) | 4 (10.5) | 0.849 |
Surgery | 6 (26.1) | 3 (8.8) | 3 (7.9) | |
Medicine | 57 (26.2) | 26 (76.5) | 31 (81.6) |
Variables | Total Population (258 Obs) | Gram Negative (119 Obs) | Gram Positive (139 Obs) | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
OR | Std. Err. | p Value | 95% CI | OR | Std. Err. | p Value | 95% CI | IRR | Std. Err. | p Value | 95% CI | |
Age | 1.04 | 0.02 | 0.009 | 1.01–1.07 | 1.08 | 0.03 | 0.004 | 1.02–1.14 | 1.02 | 0.01 | 0.249 | 0.99–1.06 |
Male sex | 1.15 | 0.36 | 0.639 | 0.63–2.11 | 0.56 | 0.24 | 0.187 | 0.24–1.32 | 2.29 | 1.03 | 0.066 | 0.95–5.55 |
Years of c-ART | 1.12 | 0.03 | 0.001 | 1.06–1.19 | 1.10 | 0.04 | 0.006 | 1.03–1.18 | 1.13 | 0.05 | 0.004 | 1.04–1.24 |
Years of HIV | 1.02 | 0.16 | 0.331 | 0.98–1.05 | 1.03 | 0.02 | 0.176 | 0.99–1.08 | 1.00 | 0.02 | 0.872 | 0.95–1.04 |
CD4 count < 200 at event | 0.67 | 0.23 | 0.255 | 0.34–1.33 | 1.09 | 0.55 | 0.859 | 0.41–2.94 | 0.39 | 0.19 | 0.050 | 0.16–1.00 |
HIV-RNA < 200 copies/mL at event | 0.96 | 0.34 | 0.912 | 0.48–1.85 | 1.04 | 0.54 | 0.932 | 0.38–2.89 | 0.91 | 0.43 | 0.844 | 0.36–2.29 |
HIV-RNA > 100.000 copies/mL at event | 0.64 | 0.35 | 0.410 | 0.22–1.83 | 0.43 | 0.36 | 0.317 | 0.08–2.25 | 0.73 | 0.52 | 0.657 | 0.18–2.93 |
HIV-RNA > 10.000 copies/mL at event | 0.78 | 0.31 | 0.538 | 0.36–1.70 | 0.50 | 0.32 | 0.278 | 0.14–1.74 | 1.00 | 0.50 | 0.997 | 0.37–2.68 |
Hospital ward | ||||||||||||
ICU | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref | Ref |
Surgery | 0.32 | 0.20 | 0.075 | 0.09–1.12 | 1.04 | 0.13 | 0.072 | 0.01–1.22 | 0.16 | 0.19 | 0.118 | 0.02–1.58 |
Medicines | 0.44 | 0.20 | 0.078 | 0.18–1.09 | 1.09 | 0.12 | 0.048 | 0.01–1.00 | 0.56 | 0.31 | 0.295 | 0.19–1.65 |
CVC-associated bacteremia | 1.16 | 0.32 | 0.582 | 0.68–2.00 | 0.94 | 0.41 | 0.892 | 0.40–2.22 | 1.28 | 0.49 | 0.521 | 0.60–2.72 |
MDR isolate | 2.46 | 0.65 | 0.001 | 1.46–4.13 | 3.37 | 1.41 | 0.004 | 1.48–7.65 | 2.12 | 0.78 | 0.041 | 1.03–4.34 |
ESBL isolate | 1.83 | 0.63 | 0.077 | 0.94–3.59 | 1.57 | 0.61 | 0.249 | 0.73–3.37 | - | - | - | - |
CRKP isolate | 5.22 | 2.99 | 0.004 | 1.70–16.08 | 4.02 | 2.18 | 0.010 | 1.39–11.65 | - | - | - | - |
MRSA isolate | 3.48 | 2.22 | 0.051 | 1.00–12.15 | - | - | - | - | 3.66 | 2.18 | 0.061 | 0.94–12.01 |
A | Unadjusted (258 Obs) | Adjusted for Age (258 Obs) | Adjusted for Age, Ward and CD4 Count * (172 Obs) | ||||||
OR | 95%CI | p Value | OR | 95%CI | p Value | OR | 95%CI | p Value | |
MDR isolate | 2.49 | 1.49–4.17 | 0.001 | 2.55 | 1.50–4.34 | 0.001 | 2.22 | 1.12–4.41 | 0.023 |
Age | 1.04 | 1.01–1.07 | 0.009 | 1.04 | 1.00–1.07 | 0.046 | |||
B | Unadjusted (258 Obs) | Adjusted for Age (258 Obs) | Adjusted for Age, Ward and CD4 Count * (172 Obs) | ||||||
OR | 95%CI | p Value | OR | 95%CI | p Value | OR | 95%CI | p Value | |
CRKP isolate | 5.22 | 1.70–16.08 | 0.004 | 4.45 | 1.39–14.22 | 0.012 | 1.84 | 0.46–7.39 | 0.388 |
Age | 1.03 | 1.00–1.06 | 0.035 | 1.03 | 1.00–1.07 | 0.074 | |||
C | Unadjusted (258 Obs) | Adjusted for Age (258 Obs) | Adjusted for Age, Ward and CD4 Count * (172 Obs) | ||||||
OR | 95%CI | p Value | OR | 95%CI | p Value | OR | 95%CI | p Value | |
CRKP isolate | 5.22 | 1.70–16.08 | 0.004 | 4.45 | 1.39–14.22 | 0.012 | 1.84 | 0.46–7.39 | 0.388 |
Age | 1.03 | 1.00–1.06 | 0.035 | 1.03 | 1.00–1.07 | 0.074 |
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Franceschini, E.; Santoro, A.; Menozzi, M.; Bacca, E.; Venturelli, C.; Zona, S.; Bedini, A.; Digaetano, M.; Puzzolante, C.; Meschiari, M.; et al. Epidemiology and Outcomes of Bloodstream Infections in HIV-Patients during a 13-Year Period. Microorganisms 2020, 8, 1210. https://doi.org/10.3390/microorganisms8081210
Franceschini E, Santoro A, Menozzi M, Bacca E, Venturelli C, Zona S, Bedini A, Digaetano M, Puzzolante C, Meschiari M, et al. Epidemiology and Outcomes of Bloodstream Infections in HIV-Patients during a 13-Year Period. Microorganisms. 2020; 8(8):1210. https://doi.org/10.3390/microorganisms8081210
Chicago/Turabian StyleFranceschini, E., Antonella Santoro, Marianna Menozzi, Erica Bacca, Claudia Venturelli, Stefano Zona, Andrea Bedini, Margherita Digaetano, Cinzia Puzzolante, Marianna Meschiari, and et al. 2020. "Epidemiology and Outcomes of Bloodstream Infections in HIV-Patients during a 13-Year Period" Microorganisms 8, no. 8: 1210. https://doi.org/10.3390/microorganisms8081210