Community-associated methicillin-resistant Staphylococcus aureus skin and soft-tissue infection in HIV-infected patients.
BACKGROUND
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as the most common cause of skin and soft tissue infections (SSTIs).


METHODS
Retrospective chart review of 43 adult HIV-infected patients with CA-MRSA SSTI was conducted.


RESULTS
Antibiotic susceptibility was as follows: vancomycin (100%), rifampin (100%), gentamicin (97.7%), tetracycline (96.5%), trimethoprim-sulfamethoxazole (95.2%), clindamycin (89.5%), levofloxacin (66.7%), and erythromycin (6.9%). At SSTI presentation, 58.5% of patients had CD4 counts greater than 200 cells/uL, 82.9% had a viral load (VL) below 100 000 log copies/mL, 6 of whom had undetectable VL. All 43 patients received empiric antibiotic therapy. Additionally, 34 patients underwent incision and drainage (I&D). For the 37 patients with follow-up data available at 4 weeks, 30 of the infections were resolved/resolving and 7 had no improvement or worsened.


CONCLUSIONS
A majority of our patients with CA-MRSA SSTI did not have immunological/virological markers consistent with severe HIV/AIDS disease at time of presentation.
Department of Medicine, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island, USA. ttonytrinh@gmail.com
T Tony
TT
Trinh
William R
WR
Short
Leonard A
LA
Mermel
D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D017714:Community-Acquired Infections / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D012189:Retrospective Studies; D018461:Soft Tissue Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D013207:Staphylococcal Skin Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D019562:Viral Load; D055815:Young Adult
D000900:Anti-Bacterial Agents