Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study
Objectives Incidence rates (IRs) of Staphylococcus aureus bacteraemia (SAB) are known to be higher in HIV‐infected individuals than in the general population, but have not been assessed in the era of highly active antiretroviral therapy. Methods From 1 January 1995 to 31 December 2007, all Danish HI...
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| Veröffentlicht in: | HIV medicine 2012-01, Vol.13 (1), p.45-53 |
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| creator | Larsen, MV Harboe, ZB Ladelund, S Skov, R Gerstoft, J Pedersen, C Larsen, CS Obel, N Kronborg, G Benfield, T |
| description | Objectives
Incidence rates (IRs) of Staphylococcus aureus bacteraemia (SAB) are known to be higher in HIV‐infected individuals than in the general population, but have not been assessed in the era of highly active antiretroviral therapy.
Methods
From 1 January 1995 to 31 December 2007, all Danish HIV‐infected individuals (n=4871) and population controls (n=92 116) matched on age and sex were enrolled in a cohort and all cases of SAB were registered. IRs and risk factors were estimated using time‐updated Poisson regression analysis.
Results
We identified 329 cases of SAB in 284 individuals, of whom 132 individuals were infected with HIV and 152 were not [crude IR ratio (IRR) 24.2; 95% confidence interval (CI) 19.5–30.0, for HIV‐infected vs. non‐HIV‐infected individuals]. Over time, IR declined for HIV‐infected individuals (IRR 0.40). Injecting drug users (IDUs) had the highest incidence and the smallest decline in IR, while men who have sex with men (MSM) had the largest decline over time. Among HIV‐infected individuals, a latest CD4 count MSM). Low CD4 cell count and IDU were strong predictors of SAB among HIV‐infected individuals. |
| doi_str_mv | 10.1111/j.1468-1293.2011.00937.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_920789568</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>911951461</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3997-9d72ef589e748e38e63ffd4f1c9e9a8a1a9ceb9cec9dcda650e266950ed363cf3</originalsourceid><addsrcrecordid>eNqNkU1OHDEQhS0UFH6SKyDvsurGP9PddpQNQgkgEWUBZGt57LLGo-72xHYHZpcjcIPcLSeJmyFsiSXrlez3qqT6EMKU1LSc03VNF62oKJO8ZoTSmhDJu_phDx2-fLx5qhcVa1t2gI5SWhNCOy7JW3TAqKCyYe0h-v1Vr0PEyylj652DCGP2uscWTO9HwH7EeTWL8RZGAzg4fJP1ZrXtgwnGTAnrKUKRpTYZoobB6zl1efX9z69HPzooz7a8WP_T20n3CbsYBkylbHAOmBHSfcQajzr7MN6XKdiEVYgZpzzZ7Tu070oG3j_rMbr78vn2_LK6_nZxdX52XRkuZVdJ2zFwjZDQLQRwAS13zi4cNRKkFppqaWBZrpHWWN02BMpeZBHLW24cP0Yfdn03MfyYIGU1-GSg7_UIYUpKMtIJ2bTidSctqy2bp8Updk4TQ0oRnNpEP-i4VZSomaNaqxmXmnGpmaN64qgeSvTkeci0HMC-BP-BK4ZPO8O972H7341VwVIK_heEBK71</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>911951461</pqid></control><display><type>article</type><title>Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study</title><source>Wiley Free Content</source><source>MEDLINE</source><source>IngentaConnect Free/Open Access Journals</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Larsen, MV ; Harboe, ZB ; Ladelund, S ; Skov, R ; Gerstoft, J ; Pedersen, C ; Larsen, CS ; Obel, N ; Kronborg, G ; Benfield, T</creator><creatorcontrib>Larsen, MV ; Harboe, ZB ; Ladelund, S ; Skov, R ; Gerstoft, J ; Pedersen, C ; Larsen, CS ; Obel, N ; Kronborg, G ; Benfield, T</creatorcontrib><description>Objectives
Incidence rates (IRs) of Staphylococcus aureus bacteraemia (SAB) are known to be higher in HIV‐infected individuals than in the general population, but have not been assessed in the era of highly active antiretroviral therapy.
Methods
From 1 January 1995 to 31 December 2007, all Danish HIV‐infected individuals (n=4871) and population controls (n=92 116) matched on age and sex were enrolled in a cohort and all cases of SAB were registered. IRs and risk factors were estimated using time‐updated Poisson regression analysis.
Results
We identified 329 cases of SAB in 284 individuals, of whom 132 individuals were infected with HIV and 152 were not [crude IR ratio (IRR) 24.2; 95% confidence interval (CI) 19.5–30.0, for HIV‐infected vs. non‐HIV‐infected individuals]. Over time, IR declined for HIV‐infected individuals (IRR 0.40). Injecting drug users (IDUs) had the highest incidence and the smallest decline in IR, while men who have sex with men (MSM) had the largest decline over time. Among HIV‐infected individuals, a latest CD4 count <100 cells/μL was the strongest independent predictor of SAB (IRR 10.2). Additionally, HIV transmission group was associated with risk of SAB. MSM were more likely to have hospital‐acquired SAB, a low CD4 cell count and AIDS at the time of HIV acquisition compared with IDUs.
Conclusions
We found that the incidence of SAB among HIV‐infected individuals declined during the study period, but remained higher than that among HIV‐uninfected individuals. There was an unevenly distributed burden of SAB among HIV transmission groups (IDU>MSM). Low CD4 cell count and IDU were strong predictors of SAB among HIV‐infected individuals.</description><identifier>ISSN: 1464-2662</identifier><identifier>EISSN: 1468-1293</identifier><identifier>DOI: 10.1111/j.1468-1293.2011.00937.x</identifier><identifier>PMID: 21819526</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Acquired immune deficiency syndrome ; Adult ; Aged ; AIDS-Related Opportunistic Infections - epidemiology ; AIDS-Related Opportunistic Infections - microbiology ; bacteraemia ; Bacteremia ; Bacteremia - microbiology ; CD4 antigen ; Denmark - epidemiology ; Disease transmission ; Drug abuse ; Epidemiologic Methods ; epidemiology ; Female ; highly active antiretroviral therapy ; HIV ; Human immunodeficiency virus ; Humans ; Incidence ; injecting drug use ; Male ; Middle Aged ; Regression analysis ; Risk Factors ; Sex ; Staphylococcal Infections - epidemiology ; Staphylococcus aureus</subject><ispartof>HIV medicine, 2012-01, Vol.13 (1), p.45-53</ispartof><rights>2011 British HIV Association</rights><rights>2011 British HIV Association.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3997-9d72ef589e748e38e63ffd4f1c9e9a8a1a9ceb9cec9dcda650e266950ed363cf3</citedby><cites>FETCH-LOGICAL-c3997-9d72ef589e748e38e63ffd4f1c9e9a8a1a9ceb9cec9dcda650e266950ed363cf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1468-1293.2011.00937.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1468-1293.2011.00937.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21819526$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Larsen, MV</creatorcontrib><creatorcontrib>Harboe, ZB</creatorcontrib><creatorcontrib>Ladelund, S</creatorcontrib><creatorcontrib>Skov, R</creatorcontrib><creatorcontrib>Gerstoft, J</creatorcontrib><creatorcontrib>Pedersen, C</creatorcontrib><creatorcontrib>Larsen, CS</creatorcontrib><creatorcontrib>Obel, N</creatorcontrib><creatorcontrib>Kronborg, G</creatorcontrib><creatorcontrib>Benfield, T</creatorcontrib><title>Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study</title><title>HIV medicine</title><addtitle>HIV Med</addtitle><description>Objectives
Incidence rates (IRs) of Staphylococcus aureus bacteraemia (SAB) are known to be higher in HIV‐infected individuals than in the general population, but have not been assessed in the era of highly active antiretroviral therapy.
Methods
From 1 January 1995 to 31 December 2007, all Danish HIV‐infected individuals (n=4871) and population controls (n=92 116) matched on age and sex were enrolled in a cohort and all cases of SAB were registered. IRs and risk factors were estimated using time‐updated Poisson regression analysis.
Results
We identified 329 cases of SAB in 284 individuals, of whom 132 individuals were infected with HIV and 152 were not [crude IR ratio (IRR) 24.2; 95% confidence interval (CI) 19.5–30.0, for HIV‐infected vs. non‐HIV‐infected individuals]. Over time, IR declined for HIV‐infected individuals (IRR 0.40). Injecting drug users (IDUs) had the highest incidence and the smallest decline in IR, while men who have sex with men (MSM) had the largest decline over time. Among HIV‐infected individuals, a latest CD4 count <100 cells/μL was the strongest independent predictor of SAB (IRR 10.2). Additionally, HIV transmission group was associated with risk of SAB. MSM were more likely to have hospital‐acquired SAB, a low CD4 cell count and AIDS at the time of HIV acquisition compared with IDUs.
Conclusions
We found that the incidence of SAB among HIV‐infected individuals declined during the study period, but remained higher than that among HIV‐uninfected individuals. There was an unevenly distributed burden of SAB among HIV transmission groups (IDU>MSM). Low CD4 cell count and IDU were strong predictors of SAB among HIV‐infected individuals.</description><subject>Acquired immune deficiency syndrome</subject><subject>Adult</subject><subject>Aged</subject><subject>AIDS-Related Opportunistic Infections - epidemiology</subject><subject>AIDS-Related Opportunistic Infections - microbiology</subject><subject>bacteraemia</subject><subject>Bacteremia</subject><subject>Bacteremia - microbiology</subject><subject>CD4 antigen</subject><subject>Denmark - epidemiology</subject><subject>Disease transmission</subject><subject>Drug abuse</subject><subject>Epidemiologic Methods</subject><subject>epidemiology</subject><subject>Female</subject><subject>highly active antiretroviral therapy</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Incidence</subject><subject>injecting drug use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Regression analysis</subject><subject>Risk Factors</subject><subject>Sex</subject><subject>Staphylococcal Infections - epidemiology</subject><subject>Staphylococcus aureus</subject><issn>1464-2662</issn><issn>1468-1293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU1OHDEQhS0UFH6SKyDvsurGP9PddpQNQgkgEWUBZGt57LLGo-72xHYHZpcjcIPcLSeJmyFsiSXrlez3qqT6EMKU1LSc03VNF62oKJO8ZoTSmhDJu_phDx2-fLx5qhcVa1t2gI5SWhNCOy7JW3TAqKCyYe0h-v1Vr0PEyylj652DCGP2uscWTO9HwH7EeTWL8RZGAzg4fJP1ZrXtgwnGTAnrKUKRpTYZoobB6zl1efX9z69HPzooz7a8WP_T20n3CbsYBkylbHAOmBHSfcQajzr7MN6XKdiEVYgZpzzZ7Tu070oG3j_rMbr78vn2_LK6_nZxdX52XRkuZVdJ2zFwjZDQLQRwAS13zi4cNRKkFppqaWBZrpHWWN02BMpeZBHLW24cP0Yfdn03MfyYIGU1-GSg7_UIYUpKMtIJ2bTidSctqy2bp8Updk4TQ0oRnNpEP-i4VZSomaNaqxmXmnGpmaN64qgeSvTkeci0HMC-BP-BK4ZPO8O972H7341VwVIK_heEBK71</recordid><startdate>201201</startdate><enddate>201201</enddate><creator>Larsen, MV</creator><creator>Harboe, ZB</creator><creator>Ladelund, S</creator><creator>Skov, R</creator><creator>Gerstoft, J</creator><creator>Pedersen, C</creator><creator>Larsen, CS</creator><creator>Obel, N</creator><creator>Kronborg, G</creator><creator>Benfield, T</creator><general>Blackwell Publishing Ltd</general><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>7X8</scope><scope>7QL</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope></search><sort><creationdate>201201</creationdate><title>Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study</title><author>Larsen, MV ; Harboe, ZB ; Ladelund, S ; Skov, R ; Gerstoft, J ; Pedersen, C ; Larsen, CS ; Obel, N ; Kronborg, G ; Benfield, T</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3997-9d72ef589e748e38e63ffd4f1c9e9a8a1a9ceb9cec9dcda650e266950ed363cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Adult</topic><topic>Aged</topic><topic>AIDS-Related Opportunistic Infections - epidemiology</topic><topic>AIDS-Related Opportunistic Infections - microbiology</topic><topic>bacteraemia</topic><topic>Bacteremia</topic><topic>Bacteremia - microbiology</topic><topic>CD4 antigen</topic><topic>Denmark - epidemiology</topic><topic>Disease transmission</topic><topic>Drug abuse</topic><topic>Epidemiologic Methods</topic><topic>epidemiology</topic><topic>Female</topic><topic>highly active antiretroviral therapy</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Incidence</topic><topic>injecting drug use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Regression analysis</topic><topic>Risk Factors</topic><topic>Sex</topic><topic>Staphylococcal Infections - epidemiology</topic><topic>Staphylococcus aureus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Larsen, MV</creatorcontrib><creatorcontrib>Harboe, ZB</creatorcontrib><creatorcontrib>Ladelund, S</creatorcontrib><creatorcontrib>Skov, R</creatorcontrib><creatorcontrib>Gerstoft, J</creatorcontrib><creatorcontrib>Pedersen, C</creatorcontrib><creatorcontrib>Larsen, CS</creatorcontrib><creatorcontrib>Obel, N</creatorcontrib><creatorcontrib>Kronborg, G</creatorcontrib><creatorcontrib>Benfield, T</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>HIV medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Larsen, MV</au><au>Harboe, ZB</au><au>Ladelund, S</au><au>Skov, R</au><au>Gerstoft, J</au><au>Pedersen, C</au><au>Larsen, CS</au><au>Obel, N</au><au>Kronborg, G</au><au>Benfield, T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study</atitle><jtitle>HIV medicine</jtitle><addtitle>HIV Med</addtitle><date>2012-01</date><risdate>2012</risdate><volume>13</volume><issue>1</issue><spage>45</spage><epage>53</epage><pages>45-53</pages><issn>1464-2662</issn><eissn>1468-1293</eissn><abstract>Objectives
Incidence rates (IRs) of Staphylococcus aureus bacteraemia (SAB) are known to be higher in HIV‐infected individuals than in the general population, but have not been assessed in the era of highly active antiretroviral therapy.
Methods
From 1 January 1995 to 31 December 2007, all Danish HIV‐infected individuals (n=4871) and population controls (n=92 116) matched on age and sex were enrolled in a cohort and all cases of SAB were registered. IRs and risk factors were estimated using time‐updated Poisson regression analysis.
Results
We identified 329 cases of SAB in 284 individuals, of whom 132 individuals were infected with HIV and 152 were not [crude IR ratio (IRR) 24.2; 95% confidence interval (CI) 19.5–30.0, for HIV‐infected vs. non‐HIV‐infected individuals]. Over time, IR declined for HIV‐infected individuals (IRR 0.40). Injecting drug users (IDUs) had the highest incidence and the smallest decline in IR, while men who have sex with men (MSM) had the largest decline over time. Among HIV‐infected individuals, a latest CD4 count <100 cells/μL was the strongest independent predictor of SAB (IRR 10.2). Additionally, HIV transmission group was associated with risk of SAB. MSM were more likely to have hospital‐acquired SAB, a low CD4 cell count and AIDS at the time of HIV acquisition compared with IDUs.
Conclusions
We found that the incidence of SAB among HIV‐infected individuals declined during the study period, but remained higher than that among HIV‐uninfected individuals. There was an unevenly distributed burden of SAB among HIV transmission groups (IDU>MSM). Low CD4 cell count and IDU were strong predictors of SAB among HIV‐infected individuals.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21819526</pmid><doi>10.1111/j.1468-1293.2011.00937.x</doi><tpages>9</tpages></addata></record> |
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| ispartof | HIV medicine, 2012-01, Vol.13 (1), p.45-53 |
| issn | 1464-2662 1468-1293 |
| language | eng |
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| source | Wiley Free Content; MEDLINE; IngentaConnect Free/Open Access Journals; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Acquired immune deficiency syndrome Adult Aged AIDS-Related Opportunistic Infections - epidemiology AIDS-Related Opportunistic Infections - microbiology bacteraemia Bacteremia Bacteremia - microbiology CD4 antigen Denmark - epidemiology Disease transmission Drug abuse Epidemiologic Methods epidemiology Female highly active antiretroviral therapy HIV Human immunodeficiency virus Humans Incidence injecting drug use Male Middle Aged Regression analysis Risk Factors Sex Staphylococcal Infections - epidemiology Staphylococcus aureus |
| title | Major but differential decline in the incidence of Staphylococcus aureus bacteraemia in HIV‐infected individuals from 1995 to 2007: a nationwide cohort study |
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