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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
12:18

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)

Published on: February 9, 2011

Risks for methicillin-resistant Staphylococcus aureus colonization or infection among patients with HIV infection

S K Ramsetty1, L L Stuart, R T Blake

  • 1Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA. ramsett@musc.edu

HIV Medicine
|January 12, 2010
PubMed
Abstract

Insights

HIV patients with a low CD4 count or recent antibiotic exposure face higher methicillin-resistant Staphylococcus aureus (MRSA) risks. Antiretroviral therapy (ART) use significantly reduced MRSA risk in this population.

Area of Science:

  • Infectious Diseases
  • HIV/AIDS Research
  • Microbiology

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) poses varying risks to individuals with HIV infection.
  • The specific epidemiology of USA-300 community-acquired MRSA (CA-MRSA) in this population remains incompletely understood.

Purpose of the Study:

  • To identify risk factors for MRSA colonization or infection in HIV-infected outpatients.
  • To characterize the prevalence and risk factors for USA-300 CA-MRSA strains in this cohort.

Main Methods:

  • Retrospective review of 900 HIV-infected outpatients from 2002-2007.
  • Multivariate logistic regression (MLR) to determine MRSA risk factors.
  • Pulsed-field gel electrophoresis (PFGE) for USA-300 strain identification.

Main Results:

  • 8% (72/900) of HIV patients had MRSA colonization or infection.
  • Past antibiotic exposure (OR 3.4) and nadir CD4 count <200 cells/µL (OR 2.5) were significant MRSA risks.
  • Antiretroviral therapy (ART) use within the past year decreased MRSA risk (OR 0.16).
  • 89% of identified strains were USA-300.
  • Skin or soft tissue infection (SSTI) predicted USA-300 infection (OR 5.9).

Conclusions:

  • Low CD4 count nadir (<200 cells/µL) and prior antibiotic exposure are key risks for MRSA in HIV patients.
  • SSTI was the primary predictor for USA-300 infection, limiting broader predictive capabilities.
  • ART use within the preceding year demonstrated a protective effect against MRSA colonization and infection.

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