Publication:

Surgical site infections in human immunodeficiency virus positive patients and their correlation with CD4 count

Background The CD4 count is like a snapshot of how well the immune system is functioning. The progressive failure of the immune system caused by the human immunodeficiency virus (HIV) can increase the possibility of developing surgical site infections (SSI) after surgery. Study about the incidence of SSI and their correlation with CD4 count in HIV positive patients has not been done in India. The present study was aimed to find the incidence and microbiological profile of SSI among HIV positive patients, and the correlation between SSI and CD4 count.

Methods One hundred forty-six HIV positive patients >18 years of age scheduled for surgery were included. CD4 count of each patient was noted. The primary outcome measure was the incidence of SSI, whereas secondary outcome measures were the correlation of SSI with CD4 count and microbiological profile of infective material. Intergroup comparison of categorical, and continuous variables was done using the chi-square test/Fisher’s exact test and unpaired ‘t’ test respectively.

Results The incidence of SSI in HIV positive patients was 14/146 (9.6%). The incidence of SSI was significantly higher among patients with CD4 count 500 (0.9 %). Mean±SD of CD4 count in patients without SSI and with SSI was 712.5±238.9 and 330.1±118.1 (cells/mm3) respectively (p<0.001). Klebsiella pneumoniae was the most common organism isolated in this study.

Conclusions SSI is frequent in HIV positive patients whose CD4 count is <200 cells/mm3.