NOTES Nosocomial Infections in Human Immunodeficiency Virus–Infected Patients in a Long-Term-Care Setting

To our knowledge, the epidemiology of hospital-acquired infections in human immunodeficiency virus (HIV)–infected patients during long-term care has not been reported. For 13 months, we observed HIV-infected patients (50 men and 15 women) in a dedicated 21-bed unit in a long-term-care facility to determine the rate of nosocomial infections. The mean age of the patients was 39 years (range, 22–78 years); 74 % of the patients had CD4 cell counts of 200/mm3. There was a total of 152 infections (24 infections per 1,000 long-term-care days). The factors associated with the occurrence of a nosocomial infection were low CD4 cell counts, poor functional status, and longer duration of stays at the facility. The three most common infections were Clostridium difficile– associated diarrhea, primary bacteremia, and urinary tract infection. Eighteen hospital-manifested opportunistic infections occurred. More than 50 % of the cases of bacteremia were due to multidrug-resistant organisms. Nosocomial infections occur commonly in HIV-infected patients in long-term care and thus are important considerations in patient management. Patients with HIV infection who require long-term subacute tional levels were assessed with use of the Barthel index [2]; scores of 50 indicate moderate-to-severe dependence. Cate-nursing care have many risk factors for infection including immunosuppression, the presence of invasive devices, and the goric data were evaluated with the x2 test, and continuou