Risk Factors for Fungemia in Children Infected with Human Immunodeficiency Virus: A Case-Control Study
To define the risk factors related to the occurrence of fungemia in children infected with human immunodeficiency virus (HIV), we performed a matched case-control study. During a 6-year period (1987–1993), fungemia developed in 22 (6.3%)of 347 HIV-infected children observed at the Pediatric Branch o...
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| Veröffentlicht in: | Clinical infectious diseases 1996-09, Vol.23 (3), p.515-521 |
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| creator | Gonzalez, Corina E. Venzon, David Lee, Sondra Mueller, Brigitta U. Pizzo, Phillip A. Walsh, Thomas J. |
| description | To define the risk factors related to the occurrence of fungemia in children infected with human immunodeficiency virus (HIV), we performed a matched case-control study. During a 6-year period (1987–1993), fungemia developed in 22 (6.3%)of 347 HIV-infected children observed at the Pediatric Branch of the National Cancer Institute. Each of these 22 cases was matched by age and gender with three controls. Multiple logistic regression indicated that the best predictor of fungemia in this population was the presence of a central venous catheter placed for >90 days (P < .00001),followed by a group of risk factors composed of 10 independent variables adjusted for a CD4 cell count of < 100/μL (P < .045). Those variables included treatment with more than three antibiotics, treatment with more than three parenteral antibiotics, > 30 days of antibiotic treatment, bacterial infections, >30 days in the hospital, hypoalbuminemia, C3 (Centers for Disease Control and Prevention) classification of HIV infection, and malnourishment. We conclude that prolonged placement of central venous catheters is the most important risk factor for fungemia in HIV-infected children and that the risk of fungemia is further influenced by antibacterial therapy, catheter manipulation, and host response. |
| doi_str_mv | 10.1093/clinids/23.3.515 |
| format | Article |
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During a 6-year period (1987–1993), fungemia developed in 22 (6.3%)of 347 HIV-infected children observed at the Pediatric Branch of the National Cancer Institute. Each of these 22 cases was matched by age and gender with three controls. Multiple logistic regression indicated that the best predictor of fungemia in this population was the presence of a central venous catheter placed for >90 days (P < .00001),followed by a group of risk factors composed of 10 independent variables adjusted for a CD4 cell count of < 100/μL (P < .045). Those variables included treatment with more than three antibiotics, treatment with more than three parenteral antibiotics, > 30 days of antibiotic treatment, bacterial infections, >30 days in the hospital, hypoalbuminemia, C3 (Centers for Disease Control and Prevention) classification of HIV infection, and malnourishment. We conclude that prolonged placement of central venous catheters is the most important risk factor for fungemia in HIV-infected children and that the risk of fungemia is further influenced by antibacterial therapy, catheter manipulation, and host response.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1093/clinids/23.3.515</identifier><identifier>PMID: 8991477</identifier><identifier>CODEN: CIDIEL</identifier><language>eng</language><publisher>Chicago, IL: University of Chicago Press</publisher><subject>Adolescent ; AIDS ; AIDS/HIV ; Anti-Bacterial Agents - therapeutic use ; Antibiotics ; Biological and medical sciences ; Blood ; Case-Control Studies ; Catheterization - adverse effects ; Catheters ; CD4 Lymphocyte Count ; Child ; Child, Preschool ; Children ; Clinical Articles ; Female ; Fungemia ; Fungemia - epidemiology ; Fungemia - etiology ; HIV infections ; HIV Infections - complications ; HIV Infections - drug therapy ; HIV Infections - immunology ; human immunodeficiency virus ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infant ; Infections ; Likelihood Functions ; Logistic Models ; Male ; Medical sciences ; Multivariate Analysis ; Pediatrics ; Predisposing factors ; Risk Factors</subject><ispartof>Clinical infectious diseases, 1996-09, Vol.23 (3), p.515-521</ispartof><rights>Copyright 1996 The University of Chicago</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3705-46d3cfff61cd30c95ff0c079e9a1b3bc45fbafd393f637fbb8b42e8fb6e29ea13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/4459665$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/4459665$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,776,780,799,27901,27902,57992,58225</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3201246$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8991477$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gonzalez, Corina E.</creatorcontrib><creatorcontrib>Venzon, David</creatorcontrib><creatorcontrib>Lee, Sondra</creatorcontrib><creatorcontrib>Mueller, Brigitta U.</creatorcontrib><creatorcontrib>Pizzo, Phillip A.</creatorcontrib><creatorcontrib>Walsh, Thomas J.</creatorcontrib><title>Risk Factors for Fungemia in Children Infected with Human Immunodeficiency Virus: A Case-Control Study</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><description>To define the risk factors related to the occurrence of fungemia in children infected with human immunodeficiency virus (HIV), we performed a matched case-control study. During a 6-year period (1987–1993), fungemia developed in 22 (6.3%)of 347 HIV-infected children observed at the Pediatric Branch of the National Cancer Institute. Each of these 22 cases was matched by age and gender with three controls. Multiple logistic regression indicated that the best predictor of fungemia in this population was the presence of a central venous catheter placed for >90 days (P < .00001),followed by a group of risk factors composed of 10 independent variables adjusted for a CD4 cell count of < 100/μL (P < .045). Those variables included treatment with more than three antibiotics, treatment with more than three parenteral antibiotics, > 30 days of antibiotic treatment, bacterial infections, >30 days in the hospital, hypoalbuminemia, C3 (Centers for Disease Control and Prevention) classification of HIV infection, and malnourishment. We conclude that prolonged placement of central venous catheters is the most important risk factor for fungemia in HIV-infected children and that the risk of fungemia is further influenced by antibacterial therapy, catheter manipulation, and host response.</description><subject>Adolescent</subject><subject>AIDS</subject><subject>AIDS/HIV</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Biological and medical sciences</subject><subject>Blood</subject><subject>Case-Control Studies</subject><subject>Catheterization - adverse effects</subject><subject>Catheters</subject><subject>CD4 Lymphocyte Count</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Clinical Articles</subject><subject>Female</subject><subject>Fungemia</subject><subject>Fungemia - epidemiology</subject><subject>Fungemia - etiology</subject><subject>HIV infections</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>human immunodeficiency virus</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infant</subject><subject>Infections</subject><subject>Likelihood Functions</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Multivariate Analysis</subject><subject>Pediatrics</subject><subject>Predisposing factors</subject><subject>Risk Factors</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1v1DAURSMEKm1hzwIkL1B3mdp58Re7KmJIpUoIpiDExnIcm7pNnGIngvn3uJpotqxs-Zz3LN1bFG8I3hAs4dIMPvg-XVawgQ0l9FlxSijwklFJnuc7pqKsBYiXxVlK9xgTIjA9KU6ElKTm_LRwX316QFtt5ikm5KaItkv4ZUevkQ-oufNDH21A18FZM9se_fHzHWqXUee3cVzC1FvnjbfB7NF3H5f0AV2hRidbNlOY4zSg3bz0-1fFC6eHZF-v53nxbfvxtmnLm8-frpurm9IAx7SsWQ_GOceI6QEbSZ3DBnNppSYddKamrtOuBwmOAXddJ7q6ssJ1zFbSagLnxcVh72Ocfi82zWr0ydhh0MFOS1Jc1Cxnwv8rkhxgBURkER9EE6eUonXqMfpRx70iWD11oNYOVAUKVO4gj7xbdy_daPvjwBp65u9XrpPRg4s6GJ-OGlSYVDXL2tuDdp9yOUdc11Qy9vRLecA-zfbvEev4oBgHTlX746dqxA63X9qduoV_4H2qfg</recordid><startdate>199609</startdate><enddate>199609</enddate><creator>Gonzalez, Corina E.</creator><creator>Venzon, David</creator><creator>Lee, Sondra</creator><creator>Mueller, Brigitta U.</creator><creator>Pizzo, Phillip A.</creator><creator>Walsh, Thomas J.</creator><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>199609</creationdate><title>Risk Factors for Fungemia in Children Infected with Human Immunodeficiency Virus: A Case-Control Study</title><author>Gonzalez, Corina E. ; Venzon, David ; Lee, Sondra ; Mueller, Brigitta U. ; Pizzo, Phillip A. ; Walsh, Thomas J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3705-46d3cfff61cd30c95ff0c079e9a1b3bc45fbafd393f637fbb8b42e8fb6e29ea13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adolescent</topic><topic>AIDS</topic><topic>AIDS/HIV</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Biological and medical sciences</topic><topic>Blood</topic><topic>Case-Control Studies</topic><topic>Catheterization - adverse effects</topic><topic>Catheters</topic><topic>CD4 Lymphocyte Count</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Clinical Articles</topic><topic>Female</topic><topic>Fungemia</topic><topic>Fungemia - epidemiology</topic><topic>Fungemia - etiology</topic><topic>HIV infections</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - immunology</topic><topic>human immunodeficiency virus</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infant</topic><topic>Infections</topic><topic>Likelihood Functions</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Multivariate Analysis</topic><topic>Pediatrics</topic><topic>Predisposing factors</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gonzalez, Corina E.</creatorcontrib><creatorcontrib>Venzon, David</creatorcontrib><creatorcontrib>Lee, Sondra</creatorcontrib><creatorcontrib>Mueller, Brigitta U.</creatorcontrib><creatorcontrib>Pizzo, Phillip A.</creatorcontrib><creatorcontrib>Walsh, Thomas J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gonzalez, Corina E.</au><au>Venzon, David</au><au>Lee, Sondra</au><au>Mueller, Brigitta U.</au><au>Pizzo, Phillip A.</au><au>Walsh, Thomas J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Fungemia in Children Infected with Human Immunodeficiency Virus: A Case-Control Study</atitle><jtitle>Clinical infectious diseases</jtitle><addtitle>Clinical Infectious Diseases</addtitle><date>1996-09</date><risdate>1996</risdate><volume>23</volume><issue>3</issue><spage>515</spage><epage>521</epage><pages>515-521</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>To define the risk factors related to the occurrence of fungemia in children infected with human immunodeficiency virus (HIV), we performed a matched case-control study. During a 6-year period (1987–1993), fungemia developed in 22 (6.3%)of 347 HIV-infected children observed at the Pediatric Branch of the National Cancer Institute. Each of these 22 cases was matched by age and gender with three controls. Multiple logistic regression indicated that the best predictor of fungemia in this population was the presence of a central venous catheter placed for >90 days (P < .00001),followed by a group of risk factors composed of 10 independent variables adjusted for a CD4 cell count of < 100/μL (P < .045). Those variables included treatment with more than three antibiotics, treatment with more than three parenteral antibiotics, > 30 days of antibiotic treatment, bacterial infections, >30 days in the hospital, hypoalbuminemia, C3 (Centers for Disease Control and Prevention) classification of HIV infection, and malnourishment. We conclude that prolonged placement of central venous catheters is the most important risk factor for fungemia in HIV-infected children and that the risk of fungemia is further influenced by antibacterial therapy, catheter manipulation, and host response.</abstract><cop>Chicago, IL</cop><pub>University of Chicago Press</pub><pmid>8991477</pmid><doi>10.1093/clinids/23.3.515</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| source | Jstor Complete Legacy; Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals |
| subjects | Adolescent AIDS AIDS/HIV Anti-Bacterial Agents - therapeutic use Antibiotics Biological and medical sciences Blood Case-Control Studies Catheterization - adverse effects Catheters CD4 Lymphocyte Count Child Child, Preschool Children Clinical Articles Female Fungemia Fungemia - epidemiology Fungemia - etiology HIV infections HIV Infections - complications HIV Infections - drug therapy HIV Infections - immunology human immunodeficiency virus Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infant Infections Likelihood Functions Logistic Models Male Medical sciences Multivariate Analysis Pediatrics Predisposing factors Risk Factors |
| title | Risk Factors for Fungemia in Children Infected with Human Immunodeficiency Virus: A Case-Control Study |
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