Healthcare Associated Infections in Intensive Care Units HIV Positive Patients

Abstract

Problem statement: Healthcare Associated Infections (HAI) are frequent and important complications, most commonly affecting hospitalized patients in intensive care units. Hospital average length of stay is usually 5-10 days higher in these patients. In HIV positive/Aids patients HAI vary from 8,7 and 15% in prevalence. The aims of this study was to compare HAI data from HIV positive (HIV+) and HIV negative (HIV-) patients admitted to the adult Intensive Care Unit (ICU) of an Infectious Disease reference hospital located in the state of Ceara, Northeast Brazil. Approach: This was a retrospective study of all patients admitted to the Hospital Sao Jose ICU, from January 2006 to December 2007, which were diagnosed with a HAI. Results: During the study period, 144 cases of HAI were diagnosed in 106 patients. Sixty were HIV- and 46 HIV+. Eighty nine (62%) HAI occurred in the HIV-group. The use of invasive devices, such as mechanical ventilation, central-line catheter and vesicle catheter, was identified in 114 HAI. Pneumonia was the most prevalent HAI (83/144- 80%), almost all of them related to mechanical ventilation (81/83-96%). Density of incidence of ventilator-associated pneumonia was higher in HIV+ (HIV- : 19.9 Vs. HIV+: 24.0-p = 0.38), while the density of incidence of catheter associated urinary tract infection was higher in HIV- (HIV-: 4.5 vs. HIV+: 1.6-p = 0.09), although without statistical significance. Conclusion/Recommendation: HAI were similar in both groups. Therefore our data suggest that, HAI prevention precautions should be intensively used in all patients, especially in ICU ones, in order to minimize HAI risks and serious consequences.