Community-Associated Methicillin-Resistant Staphylococcus aureus Colonization Burden in HIV-Infected Patients

Abstract

HIV-infected patients were more likely to have a higher CA-MRSA colonization burden and carry USA300. In certain populations, enhanced community and outpatient-based infection control strategies may be needed to prevent CA-MRSA cross-transmission and infection.

Predictors of skin and soft tissue infections in HIV-infected outpatients in the community-associated methicillin-resistant Staphylococcus aureus era

“…This finding may suggest a common risk factor for acquisition of MRSA colonization and acquisition of a sexually transmitted infection. Our finding raises the possibility that groin colonization with MRSA commonly identified in this population [35,36] could be a result of, and possibly result in, sexual transmission [37,38], though other experts in the field raise the question of differentiating sexual transmission from the skin-to-skin transmission seen in athletic populations [39]. We did not observe an independent association of SSTI risk and MSM in our HIV-infected cohort, in contrast to the findings of others.…”

Methodologic considerations of household-level methicillin-resistant Staphylococcus aureus decolonization among persons living with HIV

“…Given the institutional policy requiring three consecutive negative MRSA screenings to remove the infection control flag from a patient’s record, this is not surprising. Risk factors for MRSA colonization among this population were consistent with the literature: low income, 18,31 recent hospitalization, 9,20 incarceration, 2,9,21 visiting a public gym, 8 current or recent skin abscess, 18 and illicit drug use. 8,18 Our sample had fairly well-controlled HIV; CD4 count and HIV viral load did not differ between participants who were and were not colonized with MRSA.…”

“…1 Community-associated MRSA disproportionately affects persons living with HIV (PLWH). 2 PLWH have a higher prevalence of MRSA colonization (8–20% compared to 1.5%), 2–5 higher rates of MRSA-associated skin and soft tissue infections (SSTIs), 6–8 and an increased likelihood of recurrent infection than the general population. 9,10 Colonization with MRSA is associated with an increased risk of subsequent MRSA infection.…”

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“…Key risk factors for MRSA colonization and infection have been identified as a result of these data and include substance abuse [19,20]; high-risk sexual practices in persons with greater numbers of sex partners, regardless of sexual orientation; and having a sexual partner with a known skin infection [21]. Additional risks for MRSA infection among PLHIV include male sex, incarceration history [19], lower CD4 counts [16,17,22 ], high viral load [16,23], recent hospital admission [24], b-lactam antibiotic use [15], lack of cotrimoxazole prophylaxis [17,23], and known MRSA infection in the last 12 months [15].…”

“…Additional risks for MRSA infection among PLHIV include male sex, incarceration history [19], lower CD4 counts [16,17,22 ], high viral load [16,23], recent hospital admission [24], b-lactam antibiotic use [15], lack of cotrimoxazole prophylaxis [17,23], and known MRSA infection in the last 12 months [15].…”