Clinical infection with methicillin-resistant Staphylococcus aureus among adults with HIV was associated with colonization in the groin and a history of infection, CDC researchers reported.
“High rates of community-associated and health care–associated MRSA infections have been described among HIV-infected persons, although the underlying basis for this association is unknown,” the researchers wrote in Emerging Infectious Diseases. “The prevalence of MRSA colonization among HIV-infected persons is also high, compared with that in the general US population.”
In this prospective cohort study, participants were recruited from the Atlanta VA Medical Center HIV clinic from September 2007 to April 2008. At enrollment and at two subsequent clinic visits, the participants provided specimens for S. aureus culture from the anterior nares and the groin. The participants were monitored for 24 months for MRSA clinical infections.
Among the 600 participants, MRSA colonization was found in 79 participants at baseline, 66 participants at 6 months and 62 participants at 12 months. MRSA colonization was found only in the nares for 41% of participants, in both the nares and groin for 38% of participants and in only the groin for 21% of participants.
During a 2.1-year median follow-up, there were 29 MRSA infections in 25 participants. Among the 25 participants who developed infections, 12 had MRSA colonization in the groin only or the groin and nares at baseline. The most common infections were skin and soft tissue infections, followed by pneumonia and bacteremia. MRSA clinical infection was significantly associated with MRSA colonization in the groin and a history of MRSA infection. The most common clinical isolate was USA300, which was present in 64% of the infections.
“Given the frequency of MRSA colonization in the groin and its association with clinical infection, MRSA prevention strategies (both hygienic practices and decolonization treatments) with HIV-infected adults should be used to prevent or eliminate colonization at this anatomic site to reduce MRSA clinical infections in this population,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.