Staphylococcus epidermidis Protection Against Staphylococcus aureus Colonization in People Living With Human Immunodeficiency Virus in an Inner-City Outpatient Population: A Cross-Sectional Study

Abstract

Background.People living with human immunodeficiency virus (PLWH) have been disproportionally affected by methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection, in particular by clones USA300 and USA500. However, the contribution of epidemiological, bacterial, and immunological risk factors to the excess of S aureus in PLWH remain incompletely understood.Methods.In this cross-sectional study, we determined the prevalence and molecular epidemiology of S aureus colonization in 93 PLWH attending an urban human immunodeficiency virus (HIV) clinic. Participants completed a structured interview assessing demographic information and risk factors for MRSA. Swabs were obtained from the nose, throat, and groin and cultured for S aureus and Staphylococcus epidermidis.Results.Most participants had well controlled HIV infection (89, 96% CD4 >200). Thirty-six (39%) individuals were colonized with S aureus at 1 or more body sites, including 6 (6%) with MRSA. Regular gym use was a risk factor for S aureus but not MRSA carriage. In contrast, S epidermidis was present in almost all individuals (n = 84, 90%), predominantly in the nares (n = 66, 71%). Using generalized estimating equation models, we observed that the odds of S aureus colonization were significantly and drastically reduced when S epidermidis was detected (P = .0001). After controlling for site, gender, and age, we identified that the odds of S aureus colonization were 80% less if S epidermidis was present (adjusted odds ratio, 0.20; 95% confidence interval, .09–.45; P < .0001).Conclusions.Taken together, we observed a lower prevalence of S aureus and MRSA colonization than has been previously reported in PLWH. In this cohort, colonization with S epidermidis was protective against S aureus colonization.

Prevalence of nasal colonization by methicillin-resistant Staphylococcus aureus in outpatients living with HIV/AIDS in a Referential Hospital of the Northeast of Brazil

“…The characteristics of each individual, and likewise of health processes, may influence the microbial profile of the hospital and the individual’s mucus. The prevalence of S. aureus in our study seems to be similar to worldwide frequencies reported in other studies of the general population, which have varied from 30 to 74% in various regions of the world, particularly in Latin America [ 12 , 13 ].…”

Prevalence of Staphylococcus spp. nasal colonization among doctors of podiatric medicine and associated risk factors in Spain

“…This is done by secreting various substances (including serine protease) that cause the release of host antimicrobial peptides. [ 38 , 39 ] A recent study showed that there was a lower probability of S. aureus colonization in the presence of co-colonization by Staphylococcus lugdunensis due to the production of a “lugdunin” molecule by this bacterium, which acts as an antimicrobial agent, reducing the probability of S. aureus colonization. The study showed that, among 187 hospital patients, those who naturally harbored S. lugdunensis in the nose were six times less likely to have S. aureus colonization than those who did not carry it [ 34 ].…”

Pathogenic Mechanisms and Host Interactions in Staphylococcus epidermidis Device-Related Infection

“…S. epidermidis has also been shown to influence host colonization by other species, as shown for Staphylococcus aureus (Iwase et al, 2010 ; Park et al, 2011 ). Negative correlations between these two species have been reported in humans, insinuating an antagonism between at least some strains (Frank et al, 2010 ; Sullivan et al, 2016 ). This effect is at least partially due to the secretion of factors that impact on the viability or colonization capacity of other microorganisms (Christensen et al, 2016 ; Janek et al, 2016 ).…”