Methicillin-resistant Staphylococcus aureus in HIV-infected patients

Figures & data

Table 1 Prevalence of MRSA colonization in HIV-positive patients

Patient population	No. of HIV-infected patients	Median CD4 count of the cohort	HIV patients colonized with S. aureus, %	HIV patients colonized with MRSA, %	Reference
Outpatient^a	100	450	49	2	^Citation157
Outpatient^b	243	NA	NA	3.8	^Citation58
Outpatient^c	100	NA	NA	2	^Citation158
Outpatient^c	146	328	NA	10.3	^Citation59
Outpatient^c	158	NA	27	4	^Citation65
Outpatient^c	163	NA	21.5	3.1	^Citation159
Outpatient^c	195	270	23	3	^Citation160
Outpatient^c	111	NA	64.6^d	0	^Citation55
Outpatient^c	900	NA	NA	8	^Citation79
In/outpatient^c	178	NA	NA	34.8	^Citation161
Outpatient	162	205	30	6	^Citation51
Outpatient^e	60	NA	76.7	17.4	^Citation162
Outpatient^f	107	612	58.9^d	16.8^d	^Citation54
Inpatient	81	NA	NA	17	^Citation48
Inpatient^g	239	NA	NA	31.4	^Citation53

Notes:

a ID clinic;

b Clinic for gay, lesbian and transgender patients;

c HIV clinic;

d Cumulative prevalence;

e Patients with HIV infection attending a dermatology clinic;

f MSM;

g Children admitted to a hospital in South Africa with pneumonia.

Abbreviations: MRSA, Methicillin-resistant Staphylococcus aureus; HIV, human immunodeficiency virus; NA, not available; ER, emergency room.

Table 2 Risk factors for colonization with MRSA in HIV-positive patients^a

Risk factors for colonization with MRSA in HIV-positive patients (reference)	Studies that have found no association (reference)
High HIV viral load^Citation58	^Citation54,Citation159
Low CD4 T-cell count^Citation51,Citation52,Citation58,Citation59,Citation79	^Citation54,Citation55,Citation159,Citation160
Bactrim use (protective)^Citation58,Citation59	^Citation160^b
Antibiotic use (other than Bactrim)^Citation3,Citation51,Citation52,Citation54,Citation79,Citation160
Hospitalization^Citation3,Citation160
Central venous catheter^Citation3
Dermatologic disease^Citation3
No significant association found for the following risk factors (reference)
Intravenous drug abuse (IVDU)/recreational drug use^Citation54,Citation159
ARV treatment status^Citation54
Prior MRSA infections^Citation54
Use of sports/gym facilities/shared towels^Citation54

Notes:

a Does not take into account whether isolates are community-acquired MRSA (CA-MRSA) vs hospital-acquired MRSA (HA-MRSA);

b Use associated to risk, likely because their outpatient strain was identical to their hospital strain and therefore strain was likely a HA-MRSA strain.

Abbreviations: MRSA, Methicillin-resistant Staphylococcus aureus; HIV, human immunodeficiency virus; ARV, antiretroviral.

Table 3 Risk factors for MRSA infections in HIV-positive patients

Risk factors for MRSA infections in HIV-positive patients (reference)	Studies that have found no association (reference)
Low CD4 count^Citation66,Citation70,Citation79,Citation82	^Citation75
Elevated HIV viral load^Citation66,Citation69,Citation70
Recent use of β-lactam antibiotics^Citation70 or antibiotic use^Citation3,Citation79
History of syphilis^Citation70
Bactrim use (protective)^Citation66,Citation70,Citation75	^Citation69^a
Injection drug use, type of sexual practice (MSM), or both^Citation66	^Citation82
Sex partners with skin infections^Citation75
Use of a condom (protective)^Citation75
Methamphetamine use^Citation75
Use of a public hot tub or sauna^Citation75
Routine hands on contact with customers at work^Citation75
Cumulative hospital stay^Citation3,Citation82
Invasive procedures in the previous year^Citation82
Central venous catheter^Citation3
Dermatologic disease^Citation3

Note:

a n = 1.

Abbreviations: MRSA, Methicillin-resistant Staphylococcus aureus; HIV, human immunodeficiency virus; MSM, men who have sex with men.

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