[Nosocomial infection with methicillin resistant Staphylococcus aureus in 14 human immunodeficiency virus infected patients].
BACKGROUND
Methicillin-resistant Staphylococcus aureus (MRSA) frequently occurs with nosocomial infections. Although human immunodeficiency virus (HIV) infected subjects spend a long time in hospital, the transmission of MRSA nosocomial infections in this group of patients has not been previously reported previously.


METHODS
A clinical sample of 14 HIV infected patients from an Infectious Diseases Unit, in whom MRSA had been isolated, were evaluated as part of a 6 months prospective study. The measures employed in assessing infectivity were the prospective surveillance of all those isolated and the search for carriers in associated health-workers.


RESULTS
The potential index case was a patient with an isolated MRSA pneumonia. From him, it was transmitted to his cohabitors and to the rest of the Unit. All the patients had AIDS and 13 presented with MRSA-associated symptoms. Five were admitted 30 days previously and 12 had intravenous catheters. The mean time for the appearance of the infection was 16 days. In the antibiotic investigations multiresistance was confirmed and in the 13 symptomatic cases systemic treatment with vancomycin was indicated requiring replacement by teicoplanin in 50% due to adverse reactions. Two years later, the 14 patients had died but only one in relation to MRSA. Of the health-workers, one carrier was detected. The line of decolonization with mupirocin was efficatious.


CONCLUSIONS
The MRSA nosocomial infection in HIV infected patients took place in subjects who were immunodepressed and had a prolonged mean time of hospitalization. The treatment with vancomycin and/or teicoplanin was effective in the majority of the cases.
Eulalia Valencia
M
M
Servicio de Enfermedades Infecciosas, Centro de Investigación Clínica, Instituto de Salud Carlos III, Madrid.
Enríquez
A
A
Soriano
V
V
Moreno
V
V
Laguna
F
F
González Lahoz
J
J
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy* / Q000635:transmission; D000328:Adult; D003428:Cross Infection / Q000188:drug therapy* / Q000635:transmission; D005260:Female; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000635:transmission; D013211:Staphylococcus aureus / Q000187:drug effects*