Department of Infectious Diseases, Aarhus University Hospital - Skejby, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.
J Infect. 2013 May;66(5):439-46. doi: 10.1016/j.jinf.2012.12.012. Epub 2013 Jan 24.
This study aimed to determine incidence rates (IR) and identify risk factors for severe bacterial non-AIDS infections (SBnAI) requiring hospital admission.
Data from the prospective EuroSIDA cohort were utilized to determine IRs of first diagnosis of the following SBnAI requiring hospital admission: bacteremia, endocarditis, meningitis, peritonitis, pneumonia, osteitis, and pyolonephritis. Incidence rate-ratios (IRRs) and risk factors were assessed by Poisson regression.
During 35,839 person-years of follow-up (PYFU), 275 patients were diagnosed with SBnAI (IR = 7.67 per 1000 PYFU, 95% confidence interval: 6.79-8.64). The most frequent infections were pneumonia (IR = 5.36, 4.63-6.17), bacteremia (IR = 1.14, 0.82-1.55), and pyelonephritis (IR = 0.67, 0.43-1.00). A strong risk factor for SBnAI was reduced estimated glomerular filtration rate [eGFR] (adjusted IRR = 5.07, 2.12-12.1 and IRR = 2.73, 1.63-4.56 for eGFR ≤ 60 and 60.1-90 compared to eGFR > 90, respectively). No current combined antiretroviral therapy (cART) compared with current cART use increased the risk of SBnAI (adjusted IRR = 2.96, 2.03-4.32). Other risk factors for SBnAI included current CD4+ count <350 cells/μL, female gender, age, infection with HIV through IDU, prior AIDS diagnosis, and anaemia.
Enhanced attention directed towards people with comorbidity is warranted to limit the burden of these infections.
本研究旨在确定需要住院治疗的严重细菌性非艾滋病感染（SBnAI）的发病率（IR）和识别风险因素。
利用前瞻性 EuroSIDA 队列的数据，确定以下需要住院治疗的首次诊断为 SBnAI 的感染的发病率：菌血症、心内膜炎、脑膜炎、腹膜炎、肺炎、骨炎和肾盂肾炎。通过泊松回归评估发病率比（IRR）和风险因素。
在 35839 人年的随访期间（PYFU），275 名患者被诊断为 SBnAI（IR 为 7.67/1000 PYFU，95%置信区间：6.79-8.64）。最常见的感染是肺炎（IR = 5.36，4.63-6.17）、菌血症（IR = 1.14，0.82-1.55）和肾盂肾炎（IR = 0.67，0.43-1.00）。SBnAI 的一个强烈风险因素是估算肾小球滤过率（eGFR）降低[调整后的 IRR = 5.07，2.12-12.1 和 IRR = 2.73，1.63-4.56，分别用于 eGFR ≤ 60 和 60.1-90 与 eGFR > 90 相比]。与当前使用联合抗逆转录病毒疗法（cART）相比，当前未使用 cART 增加了 SBnAI 的风险（调整后的 IRR = 2.96，2.03-4.32）。SBnAI 的其他风险因素包括当前 CD4+计数<350 个细胞/μL、女性、年龄、经 IDU 感染 HIV、既往 AIDS 诊断和贫血。
需要加强对合并症患者的关注，以减轻这些感染的负担。
