Impact of human immunodeficiency virus infection on mortality of patients who acquired healthcare associated-infection in critical care unit

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorCASTRO-LIMA, Victor Augusto Camarinha de
dc.contributor.authorBORGES, Igor C.
dc.contributor.authorJOELSONS, Daniel
dc.contributor.authorSALES, Vivian V. T.
dc.contributor.authorGUIMARAES, Thais
dc.contributor.authorHO, Yeh Li
dc.contributor.authorCOSTA, Silvia F.
dc.contributor.authorMOURA, Maria Luisa N.
dc.date.accessioned2019-09-23T14:18:21Z
dc.date.available2019-09-23T14:18:21Z
dc.date.issued2019
dc.description.abstractTo evaluate 30-day mortality in human immunodeficiency virus (HIV) and non-HIV patients who acquired a healthcare-associated infection (HAI) while in an intensive care unit (ICU), and to describe the epidemiological and microbiological features of HAI in a population with HIV. This was a retrospective cohort study that evaluated patients who acquired HAI during their stay in an Infectious Diseases ICU from July 2013 to December 2017 at a teaching hospital in Brazil. Data were obtained from hospital infection control committee reports and medical records. Statistical analysis was performed using SPSS and a multivariate model was used to evaluate risk factors associated with 30-day mortality. Epidemiological, clinical, and microbiological characteristics of HAI in HIV and non-HIV patients and 30-day mortality were also evaluated. Among 1045 patients, 77 (25 HIV, 52 non-HIV) patients acquired 106 HAI (31 HIV, 75 non-HIV patients). HIV patients were younger (45 vs 58 years, P=.002) and had more respiratory distress than non-HIV patients (60.0% vs 34.6%, P=.035). A high 30-day mortality was observed and there was no difference between groups (HIV, 52.0% vs non-HIV, 54.9%; P=.812). Ventilator-associated pneumonia (VAP) was more frequent in the HIV group compared with the non-HIV group (45.2% vs 26.7%, P=.063), with a predominance of Gram-negative organisms. Gram-positive agents were the most frequent cause of catheter associated-bloodstream infections in HIV patients. Although there was a high frequency of HAI caused by multidrug-resistant organisms (MDRO), no difference was observed between the groups (HIV, 77.8% vs non-HIV, 64.3%; P=.214). Age was the only independent factor associated with 30-day mortality (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1.01-1.1, P=.017), while diabetes mellitus (OR: 3.64, 95% CI: 0.84-15.8, P=.085) and the Sequential Organ-Failure Assessment (SOFA) score (OR: 1.16, 95% CI: 0.99-1.37, P=.071) had a tendency to be associated with death. HIV infection was not associated with a higher 30-day mortality in critical care patients with a HAI. Age was the only independent risk factor associated with death. VAP was more frequent in HIV patients, probably because of the higher frequency of respiratory conditions at admission, with a predominance of Gram-negative organisms.eng
dc.description.indexMEDLINEeng
dc.identifier.citationMEDICINE, v.98, n.23, article ID e15801, 8p, 2019
dc.identifier.doi10.1097/MD.0000000000015801
dc.identifier.eissn1536-5964
dc.identifier.issn0025-7974
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/33495
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINSeng
dc.relation.ispartofMedicine
dc.rightsopenAccesseng
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINSeng
dc.subjectcritical careeng
dc.subjecthealth care-associated infectionseng
dc.subjecthuman immunodeficiency virus infectioneng
dc.subjectinfection controleng
dc.subjectinfectious diseaseseng
dc.subjectintensive care unitseng
dc.subject.otherblood-stream infectionseng
dc.subject.otherintensive-careeng
dc.subject.othernosocomial infectionseng
dc.subject.otherhiv-infectioneng
dc.subject.othersurvivaleng
dc.subject.othermicroorganismseng
dc.subject.othermorbidityeng
dc.subject.otherpatternseng
dc.subject.otheroutcomeseng
dc.subject.othercohorteng
dc.subject.wosMedicine, General & Internaleng
dc.titleImpact of human immunodeficiency virus infection on mortality of patients who acquired healthcare associated-infection in critical care uniteng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus5
hcfmusp.contributor.author-fmusphcVICTOR AUGUSTO CAMARINHA DE CASTRO LIMA
hcfmusp.contributor.author-fmusphcIGOR CARMO BORGES
hcfmusp.contributor.author-fmusphcDANIEL JOELSONS
hcfmusp.contributor.author-fmusphcVIVIAN VIEIRA TENORIO SALES
hcfmusp.contributor.author-fmusphcTHAIS GUIMARAES
hcfmusp.contributor.author-fmusphcHO YEH LI
hcfmusp.contributor.author-fmusphcSILVIA FIGUEIREDO COSTA
hcfmusp.contributor.author-fmusphcMARIA LUISA DO NASCIMENTO MOURA
hcfmusp.description.articlenumbere15801
hcfmusp.description.issue23
hcfmusp.description.volume98
hcfmusp.origemWOS
hcfmusp.origem.pubmed31169679
hcfmusp.origem.scopus2-s2.0-85067441301
hcfmusp.origem.wosWOS:000480721300013
hcfmusp.publisher.cityPHILADELPHIAeng
hcfmusp.publisher.countryUSAeng
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