Is acquisition of methicillin-resistant Staphylococcus aureus an occupational hazard for medical students?

pected number from a general population of the same age and sex was not done. This might have affected the trend assessment , because age-related residual confounding might have partially determined the increase in non–AIDS-defining cancers (ie, the median age of HIV-infected people was 46 years in 2005 and 41 years in 2000) [1]. Taking advantage of population-based data used for assessing post-AIDS survival in Italy [2], we compared the number of observed deaths due to pancreatic cancer among persons given a diagnosis of AIDS with the expected number. Briefly, data on all Italian citizens receiving a diagnosis of AIDS from 1999 through 2005 were linked with the Italian Mortality Database (De-cember 2006 version) to update their vital status and to identify conditions present at death (for details on the linkage procedure , see Dal Maso et al [3]). The number of person-years at risk of death was computed from the date of AIDS diagnosis to the date of death or to 31 De-cember 2006. The number of observed deaths attributable to pancreatic cancer (C25 in International Classification of Diseases , Tenth Revision) was divided by the expected number, which was computed from age-and sex-specific mortality rates for the Italian general population during the years 2000–2003. Thus, the standardized mortality ratio and its 95% confidence interval for death from pancreatic cancer among people with AIDS versus the general population were computed. Of the 8537 Italian patients, aged 25– 54 years, given AIDS diagnoses from 1999 through 2005 (who accumulated 31,437 person-years at risk of death), 2634 died. Five patients had pancreatic cancer at death, versus an expected number of 0.92. The corresponding standardized mortality ratio was 5.42 (95% confidence interval, 1.71–12.74), suggesting that Italian patients with AIDS had a statistically significant higher risk of dying from pancreatic cancer than did the corresponding general population. This finding from Italy seems to confirm the substantial burden of pancreatic cancer in the risk of death among people with HIV/AIDS noted during the HAART era in France. It is in accordance with a 2.5-fold higher incidence of pancreatic cancer among HIV-infected people reported in the United States during the HAART era [4], but it contrasts with incidence data from Italy, where no excess risk for pancreatic cancer was observed during the pre-HAART era compared with the HAART era [3]. Because HAART use has been associated with an elevated frequency of diabetes [5], which is …