Nosocomial infections in the human immunodeficiency virus-infected patient: a two-year survey

Because HIV-infected patients are often hospitalized and have major defects in host defenses, we surveyed all HIV-infected patients admitted to our institution to determine incidence of infections and to risk factors for nosocomial infections.

All patients admitted during a 2-year period were monitored for nosocomial infections until their discharge, death, or transfer. Categoric data were evaluated with the Fisher Exact Test or chi 2 test. Continuous variables were compared with the t test or Mann-Whitney test.

Ten percent of patient admissions (22/210) resulted in 32 nosocomial infections. Risk factors included longer hospitalization (29.8 vs 10.8 days), urinary catheters (35% vs 11%), gastrointestinal procedures (23% vs 3%), and vascular access (41% vs 19%). The most frequent etiologic agents were gram-positive organisms, primarily Staphylococcus species (44% [14/32]).

Nosocomial infection rates for the HIV-infected patient were higher than the overall infection rate. Agents with broad-spectrum activity against gram-positive organisms, such as vancomycin, should be considered during the wait for culture results.