Analysis of the pathogen characteristics and death risk factors of bloodstream infection in AIDS patients
LI Xiang
LIU Xia
ZHENG Hong
LIANG Yunguang
WEI Xiao
Abstract：Objective To evaluate the distribution characteristics of pathogens that cause bloodstream infection in AIDS patients and to identify the risk factors that contribute to patient mortality, so as to establish a solid foundation for enhancing clinical diagnosis and treatment methods, ultimately leading to a reduction in the mortality rate. Methods The clinical data of AIDS patients with BSI admitted to the emergency department of our hospital during 2022 were analyzed retrospectively, focusing on the distribution of pathogenic bacteria. According to patients' outcome during hospitalization, they were divided into 2 groups: those who survived ( the survival group ) and those who did not ( the death group ). Logistic regression analysis was used to identify independent risk factors associated with mortality. Results Two hundred AIDS patients diagnosed with BSI were admitted to the emergency department in 2022, from which 232 strains of pathogenic bacteria were detected. The pathogens comprised 144 strains of fungi ( 62.07％ ), mainly Talaromyces marneffei ( 55.60％ ); 35 strains of Gram-negative bacteria ( 15.09％ ), with Salmonella enteritidis ( 3.88％ ) and Escherichia coli ( 3.88％ ) being the most common; 16 strains of Mycobacterium ( 6.90％ ); and 37 strains of Gram-positive bacteria (15.95％), with the majority being Staphylococcus hominis ( 3.45％ ) and Staphylococcus epidermidis ( 3.45％ ). Among the 200 patients, 49 ( 24.5％ ) died and 151 ( 75.5％ ) survived. There was no difference in gender, age, white blood cell count, C-reactive protein, serum amyloid protein, hematocrit and CD4+ T cells between the 2 groups ( P>0.05 ). Univariate analysis showed that the platelet count, albumin, and endogenous creatinine clearance rate in the death group were lower than those in the survival group, while procalcitonin, multiple bacterial infections, septic shock, acute physiological and chronic health Ⅱ scores, and sequential organ failure scores were higher than those in the survival group ( P<0.05 ), which were risk factors for patient mortality, all of which were statistically significant risk factors for mortality. Multivariate logistic regression analysis showed that decreased endogenous creatinine clearance rate ( OR=1.035 ), septic shock ( OR=10.443 ), and acute physiological and chronic health Ⅱ score > 25 ( OR=7.708 ) were independent risk factors for patient mortality. Conclusion The incidence of BSI in AIDS patients is high. This study identified fungi as the predominant pathogens responsible for BSI, which are associated with a significant mortality rate. Independent risk factors contributing to patient mortality include reduced creatinine clearance rate (Ccr), septic shock, and elevated APACHE Ⅱ scores.
Keywords：acquired immunodeficiency syndromebloodstream infectionpathogenic bacteriarisk factors for death
Publication Date：2024-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 31-34 )