Prevalence of and Risk Factors for Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Colonization in HIV-Infected Ambulatory Patients

Cenizal, Mary Jo; Hardy, R. Doug; Anderson, Marc W.; Katz, Kathy; Skiest, Daniel J.

doi:10.1097/qai.0b013e31817e9b79

Cited by 48 publications

(60 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At 11.5% prevalence, the USA500/Iberian type was the most frequently isolated strain in our population, representing 48.0% of the MRSA isolates recovered from the groin and 57.4% from the nares. This is higher than the reported prevalence of USA500 among HIV-infected patients in Dallas, TX, and New York City (range, 4.8 to 5.6%) (8,49) but lower than the reported prevalence (19%) among general patients screened at admission to another Atlanta-area hospital (21), and both USA300 and USA500 colonization has been associated with HIV infection (36).…”

Section: Discussioncontrasting

confidence: 49%

“…Several studies have demonstrated that culture of samples from additional body sites, such as the throat, axilla, perineum, or groin, in addition to the nares, increased the sensitivity of S. aureus detection, with improvements ranging from 5 to 25% (6,28,37). However, others have found that the addition of a specimen from a second body site had little impact on the overall sensitivity of MRSA recovery (8). Although other colonization studies have demonstrated a dramatic increase in MRSA detection when throat swabs were cultured in addition to the nasal swabs, we specifically sought to address the impact of carriage site on MRSA strain types and thought that strains carried in the nose and throat were likely to be the same.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Evaluation of the Impact of Direct Plating, Broth Enrichment, and Specimen Source on Recovery and Diversity of Methicillin-Resistant Staphylococcus aureus Isolates among HIV-Infected Outpatients

et al. 2011

View full text Add to dashboard Cite

We compared recovery of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) from nasal and groin swab specimens of 600 HIV-infected outpatients by selective and nonselective direct plating and broth enrichment. Swabs were collected at baseline, 6-month, and 12-month visits and cultured by direct plating to mannitol salt agar (MSA) and CHROMagar MRSA (CM) and overnight broth enrichment with subculture to MSA (broth). MRSA isolates were characterized by pulsed-field gel electrophoresis (PFGE), staphylococcal cassette chromosome mec (SCCmec) typing, and PCR for the Panton-Valentine leukocidin. At each visit, 13 to 15% of patients were colonized with MRSA and 30 to 33% were colonized with methicillin-susceptible S. aureus (MSSA). Broth, CM, and MSA detected 95%, 82%, and 76% of MRSA-positive specimens, respectively. MRSA recovery was significantly higher from broth than CM (P < 0.001) or MSA (P < 0.001); there was no significant difference in recovery between MSA and CM. MSSA recovery also increased significantly when using broth than when using MSA (P < 0.001). Among specimens collected from the groin, broth, CM, and MSA detected 88%, 54%, and 49% of the MRSA-positive isolates, respectively. Broth enrichment had a greater impact on recovery of MRSA from the groin than from the nose compared to both CM (P < 0.001) and MSA (P < 0.001). Overall, 19% of MRSA-colonized patients would have been missed with nasal swab specimen culture only. USA500/Iberian and USA300 were the most common MRSA strains recovered, and USA300 was more likely than other strain types to be recovered from the groin than from the nose (P ‫؍‬ 0.05).

show abstract

Section: Discussioncontrasting

confidence: 49%

Section: Discussionmentioning

confidence: 97%

Evaluation of the Impact of Direct Plating, Broth Enrichment, and Specimen Source on Recovery and Diversity of Methicillin-Resistant Staphylococcus aureus Isolates among HIV-Infected Outpatients

et al. 2011

View full text Add to dashboard Cite

show abstract

“…37,38 Low levels of TMP/SXT resistance is consistent with data from high-income countries demonstrating that communityacquired strains of MRSA, containing the staphylococcal cassette chromosome mec (SCCmec) type IV, are more likely to be TMP-SXT susceptible versus other SCCmec types. 39,40 Further research is warranted to determine whether TMP-SXT may have a protective effect on S. aureus nasal colonization when used as Pneumocystis jirovecii prophylaxis among HIV-infected children.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Staphylococcus aureus Nasal Carriage in Human Immunodeficiency Virus–Infected and Uninfected Children in Botswana: Prevalence and Risk Factors

et al. 2017

View full text Add to dashboard Cite

Abstract. Staphylococcus aureus is an important cause of morbidity and mortality in children in sub-Saharan Africa (SSA). A major risk factor for staphylococcal infection is S. aureus colonization of the anterior nares. We sought to define risk factors for S. aureus carriage and characterize antimicrobial resistance patterns in children in Botswana. A cross-sectional study was conducted at two clinical sites in southern Botswana. Patients under 18 years of age underwent two nasal swabs and brief interviews, 4 weeks apart. Standard microbiological techniques were used. For persistent carriers, S. aureus was isolated from swabs at both time points, and for intermittent carriers, S. aureus was isolated from only one swab. Poisson regression with robust variance estimator was used to compare prevalence of carriage and the resistance phenotypes. Among 56 enrollees, prevalence of S. aureus colonization was 55% (N = 31), of whom 42% (N = 13) were persistent carriers. Of human immunodeficiency virus-infected children, 64% (N = 9) were carriers. Risk factors for nasal carriage included a history of tuberculosis (prevalence ratio [PR] = 1.60; 95% confidence interval [CI] = 1.02, 2.51; P = 0.040) and closer proximity to health care (PR = 0.89; 95% CI = 0.80, 0.99; P = 0.048). Prior pneumonia was more common among persistent rather than intermittent carriers (PR = 2.64; 95% CI = 1.64, 4.23; P < 0.001). Methicillin-resistant S. aureus (MRSA) prevalence was 13%. Of isolates tested, 16% were resistant to three or more drugs (N = 7/44). In summary, children in southern Botswana are frequently colonized with S. aureus. Antibiotic resistance, especially MRSA, is also widespread. Antibiotic recommendations for treatment of staphylococcal infections in SSA should take cognizance of these resistance patterns.

show abstract

“…HIV-infected patients also appear to be at increased risk for persistent S. aureus nasal colonization [23] and for recurrent S. aureus infections at low CD4 + cell counts [24]. Because of increased risk for S. aureus and MRSA colonization among HIV-infected patients [19,25,26], we assessed the impact that CA-MRSA has had on this population. We performed a community and hospital study to evaluate the epidemiology of CA-MRSA in HIV-infected patients.…”

mentioning

confidence: 99%

Community‐Associated Methicillin‐ResistantStaphylococcus aureusand HIV: Intersecting Epidemics

et al. 2010

View full text Add to dashboard Cite

show abstract

Prevalence of and Risk Factors for Methicillin-Resistant Staphylococcus aureus (MRSA) Nasal Colonization in HIV-Infected Ambulatory Patients

Cited by 48 publications

References 40 publications

Evaluation of the Impact of Direct Plating, Broth Enrichment, and Specimen Source on Recovery and Diversity of Methicillin-Resistant Staphylococcus aureus Isolates among HIV-Infected Outpatients

Evaluation of the Impact of Direct Plating, Broth Enrichment, and Specimen Source on Recovery and Diversity of Methicillin-Resistant Staphylococcus aureus Isolates among HIV-Infected Outpatients

Prevalence of Staphylococcus aureus Nasal Carriage in Human Immunodeficiency Virus–Infected and Uninfected Children in Botswana: Prevalence and Risk Factors

Community‐Associated Methicillin‐ResistantStaphylococcus aureusand HIV: Intersecting Epidemics

Contact Info

Product

Resources

About