Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study^*

Abstract

all Danish HIV-infected individuals (n 5 4871) and population controls (n 5 92 116) matched on age and sex were enrolled in a cohort and all cases of SAB were registered. IRs and risk factors were estimated using time-updated Poisson regression analysis. ResultsWe identified 329 cases of SAB in 284 individuals, of whom 132 individuals were infected with HIV and 152 were not [crude IR ratio (IRR) 24.2; 95% confidence interval (CI) 19.5-30.0, for HIV-infected vs. non-HIV-infected individuals]. Over time, IR declined for HIV-infected individuals (IRR 0.40). Injecting drug users (IDUs) had the highest incidence and the smallest decline in IR, while men who have sex with men (MSM) had the largest decline over time. Among HIV-infected individuals, a latest CD4 count o100 cells/mL was the strongest independent predictor of SAB (IRR 10.2). Additionally, HIV transmission group was associated with risk of SAB. MSM were more likely to have hospital-acquired SAB, a low CD4 cell count and AIDS at the time of HIV acquisition compared with IDUs. ConclusionsWe found that the incidence of SAB among HIV-infected individuals declined during the study period, but remained higher than that among HIV-uninfected individuals. There was an unevenly distributed burden of SAB among HIV transmission groups (IDU4MSM). Low CD4 cell count and IDU were strong predictors of SAB among HIV-infected individuals.

Prevalence of opportunistic infections in HIV-positive patients in Bahrain: a four-year review (2009-2013)

“…However, Larsen et al found that incidence of S. aureus infections among HIV-infected individuals declined but remained higher than that among HIV-uninfected individuals. S. aureus infection was more common among injecting drug users and patients with low CD4 cell counts [20]. S. epidermis was detected in 15.1% of our cases; all of them originated from blood isolates.…”

Staphylococcus aureus Infections: Epidemiology, Pathophysiology, Clinical Manifestations, and Management

“…Among HIV-infected individuals, a low CD4 count was independently associated with SAB. Also, compared to injection drug users (IDUs), men who have sex with men (MSM) were likely to have a low CD4 count and to have nosocomial SAB (35). Thus, HIV-infected IDUs tend to acquire community-onset SAB as a consequence of injection drug use, whereas MSM have higher rates of nosocomial SAB.…”

“…Two studies reported incidences of SAB in HIVinfected patients of 494 per 100,000 person-years (35) and 1,960 per 100,000 person-years (36), or 24 times that of the non-HIVinfected population (35). Although much of this increase results from high rates of injection drug use in the HIV-infected population, even the non-injection drug-using HIV-infected population exhibits higher rates of SAB than those in the non-HIV-infected population (35). Among HIV-infected individuals, a low CD4 count was independently associated with SAB.…”

Predictors of Mortality in Staphylococcus aureus Bacteremia

“…AIDS secondary to HIV is one of the most common cell-mediated acquired immune deficiency states worldwide (159). The incidence of SAB among HIV-infected individuals remains higher than that among individuals not infected with HIV (25,124,138,159,260,295). This risk is directly associated with the degree of immune deficiency, with the relative risk being 31 times higher (incidence rate ratio [IRR], 31.1; 95% CI, 10.3 to 94.0) for patients with CD4 cell counts of Ͻ100 cells/l than for patients with CD4 cell counts of Ն350 cells/l (159).…”