Bloodstream infections are a frequent complication in human immunodeficiency virus (HIV)–infected adults in Africa and usually associated with a poor prognosis. We evaluated bloodstream infections across a decade in 3 prospective cross‐sectional surveys of consecutive medical admissions to the Kenyatta National Hospital, Nairobi, Kenya. Participants received standard clinical care throughout. In 1988–1989, 29.5% (28 of 95) of HIV‐positive patients had bloodstream infections, compared with 31.9% (46 of 144) in 1992 and 21.3% (43 of 197) in 1997. Bacteremia and mycobacteremia were significantly associated with HIV infection – HIV-negative patients showed much lower prevalences. Infections with Mycobacterium tuberculosis, non‐typhi species of Salmonella (NTS), and Streptococcus pneumoniae predominated. Fungemia (Cryptococcus neoformans in all cases) and malaria (Plasmodium falciparum in all cases) were uncommon. Clinical features at presentation remained similar. Significant improvements in the survival rate were recorded among patients with NTS bacteremia (20%–83%; P
Clinical Infectious Diseases (2001) 33 (2) pp. 248–256 [DOI:10.1086/321820].