Document 0834
 DOCN  M9480834
 TI    Pseudomonas aeruginosa bacteremia in HIV-infected patients.
 DT    9410
 AU    Gilbert L; Peters B; Peoples D; Frederick W; Howard University Hospital,
       Washington, DC.
 SO    Abstr Gen Meet Am Soc Microbiol. 1994;94:573 (abstract no. C-469).
       Unique Identifier : AIDSLINE ASM94/94313111
 AB    In order to analyze epidemiological and clinical aspects of Pseudomonas
       aeruginosa bacteremia (PAB) in HIV+ patients (pts), we conducted a
       retrospective study of PAB during the period 1983-1993. Of the 281 pts
       identified, 25 (20 males, 5 females) were HIV+. Their mean age was 34.5
       years and 96% were black. HIV risk factors were IVDU (8),
       homosexual/bisexual (13), heterosexual contact (3) and vertical
       transmission (1). Fifteen pts had AIDS and 14 were taking zidovudine.
       Intensive care unit (ICU) admissions were 8. Mean hospital stay for ICU
       and ward admissions were 11.8 and 8.7 days respectively. All pts were
       febrile, 9 had abnormal chest radiographs, and four grew PA from the
       lung. Observed risk factors for PAB were neutropenia (< 500/mm3) (3),
       intubation (1), central catheters (2), and shunts (3). T-helper (CD4+)
       cell counts were below 200/mm3 in 13 pts and above in 9 pts. PAB was
       nosocomial in 20 pts. No primary focus was identified in 11 pts. The
       lung was the primary site in 9 pts. Eight pts had polymicrobial
       bacteremia. Eleven (44%) pts received appropriate antimicrobial therapy.
       Overall mortality was 80% with 35% of the deaths occurring within 24
       hours of PAB. Mortality for ICU and ward admissions were 100% and 75%
       respectively. Mortality for pts with CD4+ cell counts above and below
       200/mm3 were 77% and 84% respectively. Among HIV+ pts, PAB carries a
       high mortality and is unrelated to CD4+ counts. ICU admission did not
       significantly alter PAB mortality rates. Clinicians need to be aware of
       this high mortality rate and that PAB occur commonly in HIV+ pts without
       identifiable primary foci and predisposing factors. Thus a high index of
       suspicion is needed so that appropriate therapy can be instituted
       earlier.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/DRUG THERAPY  Adult
       AIDS-Related Opportunistic Infections/DRUG THERAPY/*EPIDEMIOLOGY/
       MORTALITY  Bacteremia/DRUG THERAPY/*EPIDEMIOLOGY/MORTALITY  Comparative
       Study  Female  Hospital Units  Human  HIV Infections/*COMPLICATIONS/DRUG
       THERAPY  Intensive Care Units  Male  *Pseudomonas aeruginosa
       Pseudomonas Infections/DRUG THERAPY/*EPIDEMIOLOGY/MORTALITY
       Retrospective Studies  Risk Factors  Sex Behavior  Survival Rate
       Zidovudine/THERAPEUTIC USE  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).