Colonization with Staphylococcus aureus in HIV-infected children and adolescents in Brooklyn, NY

Abstract

Few studies have examined the epidemiology of Staphylococcus aureus (S. aureus) colonization in human immunodeficiency virus (HIV)-infected children. The goal of this study was to determine the prevalence and risk factors for S. aureus colonization in our pediatric HIV-infected patients. HIV-infected patients and age-matched controls of 2?24 years of age were recruited in the pediatric outpatient clinics at SUNY Downstate Medical Center and Kings County Hospital, in Brooklyn, NY. Nares and axillary swabs were collected from each patient and cultured. Confirmed S. aureus isolates were screened for sensitivity to antibiotics frequently used to treat staphylococcal infections. A total of 112 patients were screened; 63 HIV-infected and 49 controls. Eighteen of two hundred and twenty-four (8%) specimens grew S. aureus. Only two grew methicillin resistant S. aureus. Within the HIV-infected group, 3 of 63 (5%) patients were colonized. In contrast, 11 of 49 (22%) controls (p = 0.008, Fisher exact test) were colonized. None of the colonized patients reported taking any antibiotics in the last year. We did not find higher rates of S. aureus colonization in HIV-infected children and adolescents compared to healthy controls. The prevalence of S. aureus colonization in the HIV-infected group was significantly lower than controls, which may be related to the use of trimethoprim/sulfamethoxazole for Pneumocystis prophylaxis. The prevalence of methicillin resistant S. aureus colonization was low in both groups and is likely reflective of the low rates of both colonization and invasive disease seen with this pathogen at our institution.