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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/32209


    標題: Clinical predictors of the leading pathogens in human immunodeficiency virus-infected adults with community-onset bacteremia in the emergency department: The importance of transmission routes
    作者: Lee, Ching-Chi
    Chou, Yu-Ju
    Lin, Jiun-Nong
    Chu, Feng-Yuan
    Tang, Hung-Jen
    Lai, Chung-Hsu
    Lin, Hsi-Hsun
    Hung, Chien-Ching
    Ko, Wen-Chien
    關鍵字: bacteremia
    human immunodeficiency virus
    Salmonella enterica
    Staphylococcus aureus
    日期: 2018-06
    上傳時間: 2019-11-15 15:45:16 (UTC+8)
    出版者: ELSEVIER TAIWAN
    摘要: Background/Purpose: To investigate the clinical characteristics and pathogens of community-onset bacteremia among human immunodeficiency virus (HIV)-infected adults as well as to establish the clinical predictors of the major microorganisms. Methods: An observational cohort study was conducted retrospectively between January 2007 and December 2012. Demographic characteristics and pathogens determined from chart records were analyzed. Results: Of the 121 eligible HIV adults with bacteremia, there was a male predominance (106 patients, 87.6%); elderly individuals (age >= 65 years) accounted for only 2.5% of the study population (3 patients). Of the total microorganisms isolated (n = 123), Staphylococcus aureus (55, 44.7%) and Salmonella enterica (17, 13.8%) were the common pathogens. In a multivariate analysis, the leading two significant predictors of S. aureus infection were infective endocarditis (odds ratio, 11.49; p = 0.001) and transmission risk with injection drug users (IDUs; odds ratio, 6.22; p = 0.001). In addition, transmission risk with men who have sex with men (MSM; odds ratio, 37.49; p = 0.001) was the leading clinical predictor of S. enterica infection. In further analyses, a strong linear-by-linear correlation between S. aureus infection and IDU (gamma = 0.94, p = 0.02) as well as between S. enterica infection and MSM (gamma = 0.96, p = 0.01) was evidenced. Conclusion: Focusing on the two key pathogens in HIV-infected adults with community-onset bacteremia, IDU was one of independent predictors associated with S. aureus infection, whereas MSM was the leading risk factor of S. enterica infection. Although the proposed predictive model of these pathogens has been not established, a scoring system involving the transmission risk of HIV may be of use for the early identification of these patients for clinicians. Copyright (C) 2017, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.
    link: http://dx.doi.org/10.1016/j.jmii.2016.08.001
    關聯: Journal of Microbiology Immunology and Infection, v.51, n.3, pp.392-400
    Appears in Collections:[保健營養系(所) ] 期刊論文

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