Epidemiology and Infection

M.R.S.A.

Methicillin-resistant Staphylococcus aureus colonization in HIV-infected outpatients is common and detection is enhanced by groin culture

P. J. PETERSa1 c1, J. T. BROOKSa1, B. LIMBAGOa1, H. K. LOWERYa2, S. K. McALLISTERa1, R. MINDLEYa2, G. FOSHEIMa1, R. J. GORWITZa1, J. L. GUESTa2, J. HAGEMANa1, J. FRIDGEa2 and D. RIMLANDa2a3

a1 Centers for Disease Control and Prevention, Atlanta, GA, USA

a2 Veterans Affairs Medical Center (VAMC), Atlanta, GA, USA

a3 Emory University School of Medicine, Division of Infectious Diseases, Atlanta, GA, USA

SUMMARY

Although high rates of clinical infection with methicillin-resistant Staphylococcus aureus (MRSA) have been reported in HIV-infected adults, data on MRSA colonization are limited. We enrolled HIV-infected adults receiving care at the Atlanta VA Medical Center. Swabs from each participant's nares and groin were cultured with broth enrichment for S. aureus. Of 600 HIV-infected adults, 79 (13%) were colonized with MRSA and 180 (30%) with methicillin-susceptible S. aureus. MRSA pulsed-field gel electrophoresis types USA300 (n=44, 54%) and USA500/Iberian (n=29, 35%) predominated. Inclusion of groin swabs increased MRSA detection by 24% and USA300 detection by 38%. In multivariate analysis, MRSA colonization compared to no MRSA colonization was associated with a history of MRSA clinical infection, rarely or never using condoms, and contact with prisons and jails. In summary, the prevalence of MRSA colonization was high in this study of HIV-infected adults and detection of USA300 was enhanced by groin culture.

(Accepted August 03 2010)

(Online publication September 15 2010)

Correspondence:

c1 Author for correspondence: P. J. Peters, M.D., Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-45, Atlanta, GA 30333, USA. (Email: pjpeters@cdc.gov)

Footnotes

The data were presented in part at the 19th Society for Healthcare Epidemiology of America (SHEA) Annual Scientific Meeting 2009, San Diego, CA. Abstract Number 234.

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