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Updated: May 24, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Community-associated methicillin-resistant Staphylococcus aureus colonization in high-risk groups of HIV-infected
Kyle J Popovich1, Kimberly Y Smith, Thana Khawcharoenporn
1Rush University Medical Center, Chicago, Illinois 60612, USA. kyle_popovich@rush.edu
Background:
We examined the epidemiology of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) nasal colonization among 3 groups of human immunodeficiency virus (HIV)-infected and 1 group of HIV-negative outpatients.
Methods:
We determined prevalence and risk factors associated with MRSA colonization among women, recently incarcerated, and Hispanic HIV-infected patients and HIV-negative patients; isolates were typed by pulsed-field gel electrophoresis. Relative prevalence was calculated using Poisson regression, and logistic regression was used for multivariate analysis.
Results:
Of 601 patients, 9.3% were colonized with MRSA; 11% of HIV-infected and 4.2% of HIV-negative patients were colonized (relative prevalence, 2.6; 95% confidence interval [CI], 1.12-6.07; P = .03). Among HIV-infected patients, recently incarcerated patients had the highest colonization prevalence (15.6%) followed by women (12%); Hispanic patients had the lowest (2.8%). Eighty percent of confirmed MRSA isolates were identified as USA300. On multivariate analysis, history of incarceration or residence in alternative housing (odds ratio [OR], 2.3; 95% CI, 1.1-4.7; P = .03) was associated with MRSA colonization; Hispanic ethnicity was negatively associated (OR, 0.3; 95% CI, .11-.98; P = .045). There was a trend (OR, 1.6; 95% CI, .9-3.0; P = .097) toward geographic location of residence being associated with colonization. After controlling for incarceration, residence, and geography, HIV status was no longer significantly associated with colonization.
Conclusions:
The CA-MRSA and HIV epidemics have intersected. Examination of networks of individuals released from incarceration, both HIV positive and negative, is needed to assess the role of social networks in spread of CA-MRSA and inform prevention strategies.
Insights
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is more prevalent in HIV-infected individuals, particularly those recently incarcerated. Social networks, especially those involving individuals released from incarceration, are key to understanding and preventing CA-MRSA spread.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a growing public health concern.
- Understanding the epidemiology of CA-MRSA colonization in vulnerable populations is crucial for effective control strategies.
Purpose of the Study:
- To examine the prevalence and risk factors of CA-MRSA nasal colonization.
- To compare colonization rates between human immunodeficiency virus (HIV)-infected and HIV-negative outpatients.
- To identify specific risk factors within HIV-infected groups, including women, recently incarcerated individuals, and Hispanic patients.
Main Methods:
- Cross-sectional study involving 601 outpatients (HIV-infected and HIV-negative).
- Prevalence and risk factors for MRSA colonization determined using Poisson and logistic regression.
- Isolates characterized by pulsed-field gel electrophoresis; USA300 strain identified.
Main Results:
- Overall MRSA colonization rate was 9.3%; 11% in HIV-infected vs. 4.2% in HIV-negative patients.
- Recently incarcerated individuals (15.6%) and women (12%) among HIV-infected patients had higher colonization rates.
- History of incarceration or alternative housing (OR 2.3) was associated with colonization; Hispanic ethnicity was negatively associated (OR 0.3).
Conclusions:
- CA-MRSA and HIV epidemics show intersecting epidemiological patterns.
- Social networks of individuals released from incarceration play a significant role in CA-MRSA transmission, irrespective of HIV status.
- Further investigation into these networks is vital for developing targeted prevention strategies.
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