Prevalence and risk factors for methicillin-resistant Staphylococcus aureus in an HIV-positive cohort

Area of Science:

• Infectious Diseases
• Public Health
• HIV Medicine

Background:

• Persons living with HIV (PLWH) experience a disproportionately high burden of methicillin-resistant Staphylococcus aureus (MRSA).
• Understanding MRSA colonization prevalence and risk factors in PLWH is crucial for effective prevention strategies.

Purpose of the Study:

• To evaluate the prevalence of MRSA colonization in people living with HIV (PLWH).
• To identify risk factors associated with MRSA colonization in this population.

Main Methods:

• Adults were recruited from an HIV service clinic.
• Data collected included a risk questionnaire, specimen collection from multiple anatomic sites, and culture susceptibility testing.
• Generalized estimating equation modeling was used to identify MRSA colonization risk factors.

Main Results:

• MRSA prevalence was 15.4% among 500 participants, with colonization found in sites other than the nares in 40% of cases.
• Factors associated with lower odds of colonization included recent sexual activity and antiretroviral therapy (ART).
• Increased odds of colonization were linked to lower income, recent hospitalization, incarceration, street drug use, and skin abscesses.

Conclusions:

• Nasal screening alone is insufficient for identifying MRSA colonization in PLWH; multiple anatomic sites require screening.
• Antiretroviral therapy (ART) may offer a protective benefit against MRSA colonization.
• Risk factors such as low income, hospitalization, incarceration, and drug use highlight specific populations for targeted MRSA prevention efforts.