title: Short communication: methicillin-resistant Staphylococcus aureus infections in children and young adults infected with HIV.
abstract: The epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) infections, in particular with Panton-Valentine leukocidin (PVL)-positive strains, has not been well characterized in children and young adults with HIV infection. It is not known if PVL-positive strains of MRSA cause an increased morbidity in this population compared to PVL-negative strains. The purpose of this study was to retrospectively analyze the epidemiology of PVL-positive and PVL-negative MRSA infections in children and young adults with HIV from 2000 to 2007. Molecular typing was performed by polymerase chain reaction (PCR) for detection of the PVL genes. Staphylococcus Cassette Chromosome (SCC) mec and spa typing were performed on all PVL-positive isolates. The number of HIV patients with MRSA infection increased significantly between 2000 and 2007 ( p=0.0015). Twenty seven (87%) of the 31 MRSA isolates were from skin and soft tissue infections (SSTI). Clindamycin resistance was observed in 19% of the MRSA isolates. PVL-positive isolates bearing the type IV SCC mec element comprised 16 of 31 (52%) MRSA isolates. All the PVL-positive isolates belonged to the USA300 pulsed-field type. There was no difference in the mean CD4 count and HIV viral load between patients with PVL-positive and PVL-negative MRSA infections. PVL-positive MRSA infections were associated with more SSTI ( p=0.043) but not with increased morbidity or a higher risk of complications compared to PVL-negative MRSA infections in children and young adults with HIV.
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA. ashok.srinivasan@stjude.org
authors.forename: Ashok
authors.initials: A
authors.lastname: Srinivasan
authors.forename: Steven
authors.initials: S
authors.lastname: Seifried
authors.forename: Liang
authors.initials: L
authors.lastname: Zhu
authors.forename: Wally
authors.initials: W
authors.lastname: Bitar
authors.forename: Deo K
authors.initials: DK
authors.lastname: Srivastava
authors.forename: Jerry L
authors.initials: JL
authors.lastname: Shenep
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Bankowski
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Flynn
authors.forename: Randall T
authors.initials: RT
authors.lastname: Hayden
mesh_terms: D000293:Adolescent; D001427:Bacterial Toxins; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005098:Exotoxins / Q000502:physiology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007223:Infant; D007956:Leukocidins / Q000502:physiology; D016015:Logistic Models; D008297:Male; D008712:Methicillin / Q000627:therapeutic use; D016106:Methicillin Resistance / Q000187:drug effects / Q000502:physiology; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification / Q000502:physiology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000821:virology; D013714:Tennessee / Q000453:epidemiology; D019562:Viral Load; D055815:Young Adult
chemical_list: D001427:Bacterial Toxins; D005098:Exotoxins; D007956:Leukocidins; C078284:Panton-Valentine leukocidin; D008712:Methicillin