Another study demonstrated that the risk of S.
aureus infection among colonized HIV-infected Selleck Linsitinib patients with CD4 counts <100 cells/μL was as high as 10% for every 6-month interval over which they were colonized. Bloodstream infections and skin and soft issue infections (SSTIs) were the most common types of infection described in this study, and were largely community-acquired (CA). Furthermore, most infecting strains were identical to the colonizing S. aureus strain [2]. Historically, infections caused by methicillin-resistant Staphylococcus aureus (MRSA) impart a higher morbidity and mortality compared with infections caused by methicillin-susceptible S. aureus [5]. Among HIV-negative patients, established risk factors for MRSA colonization and infection include a history of hospitalization, a history of a surgical procedure, haemodialysis, the presence of an indwelling catheter, and residence in a long-term care facility [6]. Clinical AIDS has also been described as a risk for MRSA colonization, and this has been attributed to various behavioural factors and underlying medical conditions. Among HIV-infected patients, studies differ in their identification of risk factors for MRSA infection and have included a CD4 count <50 cells/μL, an HIV viral load
greater than 100 000 HIV-1 RNA copies/ml, HIV acquisition via men who have sex with men (MSM), use of beta-lactam antibiotics within 6 months, a history of syphilis, undergoing an invasive procedure within 12 months, prior incarceration, past or PD0332991 nmr current injecting drug use (IDU), and lack of trimethoprim-sulfamethoxazole prophylaxis for more than 4 months [7–10]. Additionally, the emerging epidemiology of USA-300 CA MRSA among HIV-infected patients has not been fully described with regard to the impact of the USA-300 CA-MRSA strain. The goal of our study was to describe the epidemiology of MRSA in our HIV-infected patient population, which predominantly consists of heterosexual
minorities, in order to identify risk factors for MRSA colonization or infection as well as those for USA-300 CA-MRSA colonization or infection. The Infectious Diseases (ID) out-patient clinic is affiliated with the Medical University of South Carolina (MUSC), a 650-bed academic medical centre located in Charleston, South Carolina, USA. We Carnitine palmitoyltransferase II performed a retrospective chart review of 900 HIV-infected patients who received care at our ID clinic from January 2002 until December 2007 to identify those who were colonized or infected with MRSA. Our study was approved by the MUSC institutional review board. To determine risk factors associated with MRSA colonization or infection, we performed an unmatched case–control study in which cases were defined as HIV-infected patients seen at least once in the ID clinic during the study period, who were colonized or infected with MRSA at any time after their HIV diagnosis.