title: Nasopharyngeal carriage of Staphylococcus aureus and carriage of tetracycline-resistant strains associated with HIV-seropositivity.
abstract: The aim of this prospective study was to investigate the relationship between carriage of antibiotic-resistant Staphylococcus aureus and infection with the human immunodeficiency virus (HIV). A total of 554 pernasal swabs was taken during a six-month period from 554 adult patients attending three outpatient clinics and from inpatients from a hospital in Nairobi, Kenya. Overall, 121 swabs (22%) yielded Staphylococcus aureus, there being significantly higher carriage in HIV-positive patients (71/264, 27%) than in HIV-negative patients (50/290, 17%); p = 0.008. Antimicrobial resistance rates were determined for 110 isolates and were high for penicillin (91%) and tetracycline (72%) and low for erythromycin (8%), methicillin (3%), gentamicin (5%) and chloramphenicol (0%). Genetic analysis showed plasmids in the range of 24-42 MDa to be associated with beta-lactamase production and plasmids in the range of 3-5 MDa to be associated with resistance to tetracycline, erythromycin and trimethoprim. All nine erythromycin-resistant strains were from HIV-positive patients (p = 0.02). There was a significant association of tetracycline resistance with HIV seropositivity (p = 0.002). The association of HIV seropositivity with Staphylococcus aureus carriage and carriage of antibiotic-resistant strains against the background of the HIV epidemic are of relevance in individual patient care and raise concern for public health.
authors.affiliation: Wellcome Trust Research Laboratories, Kilifi, Kenya.
authors.forename: M
authors.initials: M
authors.lastname: Amir
authors.forename: J
authors.initials: J
authors.lastname: Paul
authors.forename: B
authors.initials: B
authors.lastname: Batchelor
authors.forename: S
authors.initials: S
authors.lastname: Kariuki
authors.forename: J
authors.initials: J
authors.lastname: Ojoo
authors.forename: P
authors.initials: P
authors.lastname: Waiyaki
authors.forename: C
authors.initials: C
authors.lastname: Gilks
mesh_terms: D000328:Adult; D000351:Africa, Eastern; D001434:Bacteriophage Typing; D002353:Carrier State; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000382:microbiology*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D009305:Nasopharynx / Q000382:microbiology; D010957:Plasmids / Q000032:analysis; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000150:complications*; D013211:Staphylococcus aureus / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D013753:Tetracycline Resistance