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

被引:21
作者
Farley, Jason E. [1 ]
Hayat, Matthew J. [2 ,3 ]
Sacamano, Paul L. [4 ]
Ross, Tracy [5 ]
Carroll, Karen [5 ]
机构
[1] Johns Hopkins Univ, Sch Nursing, Dept Community & Publ Hlth, Baltimore, MD 21205 USA
[2] Georgia State Univ, Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30303 USA
[3] Georgia State Univ, Sch Publ Hlth, Dept Biostat, Atlanta, GA 30303 USA
[4] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA
[5] Johns Hopkins Univ, Sch Med, Dept Med Microbiol, Baltimore, MD 21205 USA
基金
美国国家卫生研究院;
关键词
Methicillin-resistant Staphylococcus aureus; HIV; Prevalence; Risk; Anatomic site; INFECTED PERSONS; SURVEILLANCE CULTURES; MRSA INFECTION; COLONIZATION; SITES; MEN; MICROBIOLOGY; POPULATION; CARRIAGE; TRENDS;
D O I
10.1016/j.ajic.2014.12.024
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Persons living with HIV (PLWH) are disproportionately burdened with methicillin-resistant Staphylococcus aureus (MRSA). Our objective was to evaluate prevalence and risks for MRSA colonization in PLWH. Methods: Adults were recruited from Johns Hopkins University AIDS Service in Baltimore, Maryland. A risk questionnaire and specimen collection from anatomic sites with culture susceptibility and genotyping were completed. Generalized estimating equation modeling identified MRSA colonization risk factors. Results: Of 500 participants, mostwere black (69%), on antiretroviral therapy (ART) (87%), with undetectable viral loads (73.4%). Median CD4 count was 487 cells/mm(3) (interquartile range, 316-676.5 cells/mm(3)). MRSA prevalence was 15.4%, predominantly from the nares (59.7%). Forty percent were nares negative but were colonized elsewhere. Lower odds for colonizationwere associated with recent sexual activity (adjusted odds ratio [AOR] = 0.84, P < .001) and ART (AOR = 0.85, P = .011). Increased odds were associated with lower income (<$25,000 vs >$75,000; AOR = 2.68, P < .001), recent hospitalization (AOR = 1.54, P < .001), incarceration (AOR = 1.55, P < .001), use of street drugs (AOR = 1.43, P < .001), and skin abscess (AOR = 1.19, P < .001). Conclusions: Even with high MRSA prevalence, the proportion identified through nares surveillance alone was low, indicating the importance of screening multiple anatomic sites. Associations were not found with same-sex coupling or black race. MRSA prevention might be a benefit of ART in PLWH. Copyright (C) 2015 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc.
引用
收藏
页码:329 / 335
页数:7
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