1005. HIV-Associated Bloodstream Infection (BSI): Trends Over 7 Years

Abstract

BackgroundPatients with HIV are known to be at risk for bacteremia. Whether the type of organisms changed over time is uncertain. We present a review of bacteremia in HIV-patients during 2010–2016.MethodsWe reviewed blood culture (BC) results (January 1, 2010–December 31, 2016), selected patients with BSI, defined their HIV status, the place of onset (community onset [CO]: 0–3 days after admission; hospital onset [HO]: ≥4 days), patient demographics, the source and organism distribution and compared patients with and without HIV.ResultsWe encountered 5,179 BSI episodes, 93 were among 73 HIV-patients (table). HIV patients were younger, and more likely to be African Americans. Majority of cases were community onset (79.1% and 74.5% in cases with/without HIV, respectively). The three most common organisms in HIV patients were Staphylococcus aureus (SA), Escherichia coli (EC) and Streptococcus pneumoniae (SPN) and in non-HIV patients SA, EC, and Klebsiella pneumoniae (KP). While the rate of SA (25.3%–22.0%), SPN (2%–3%), and KP (10.2%–8.4%) remained stable during the study period, EC rate increased (18.5–25.7; P = 0.002). HIV patients were more likely to have the respiratory tract as the source of BSI.ConclusionHIV-patients remain at higher risk for SPN and to have a respiratory source of BSI but the top causes of BSI in patients with and without HIV are SA and EC. Whether the higher rate of SPN among HIV patients is related to poor compliance with vaccination or suboptimal immune status is uncertain. Further studies are needed to compare pneumococcal vaccination compliance rate in patients with or without HIV.Table: Bloodstream Infection: Organism Distribution in Patients Stratified to Their HIV Status.Patient CharacteristicsCommon OrganismsSourceHIV StatusAge (years): mean ± SDMaleAASAECSPNKPVASTBUTIResYes (93)48.5 ± 13.160.286.028.019.411.84.316.317.522.619.4No (5,086)63.2 ± 17.253.057.624.021.62.29.021.218.324.38.4 P <0.0010.2<0.0010.40.7<0.0010.080.30.90.8<0.001African Americans; vascular; Soft tissue/bone; urinary tract; respiratory. Disclosures All authors: No reported disclosures.