title: Prevalence of and risk factors for MRSA colonization in HIV-positive outpatients in Singapore.
abstract: BACKGROUND
  Whilst there have been studies on the risks and outcomes of MRSA colonization and infections in HIV-positive patients, local data is limited on the risk factors for MRSA colonization among these patients. We undertook this study in a tertiary HIV care centre to document the risk factors for colonization and to determine the prevalence of MRSA colonization among HIV-positive outpatients in Singapore.
  
  
  METHODS
  This was a cross-sectional study in which factors associated with MRSA positivity among patients with HIV infection were evaluated. A set of standardized questionnaire and data collection forms were available to interview all recruited patients. Following the interview, trained nurses collected swabs from the anterior nares/axilla/groin (NAG), throat and peri-anal regions. Information on demographics, clinical history, laboratory results and hospitalization history were retrieved from medical records.
  
  
  RESULTS
  MRSA was detected in swab cultures from at least 1 site in 15 patients (5.1%). Inclusion of throat and/or peri-anal swabs increased the sensitivity of NAG screening by 20%. Predictors for MRSA colonization among HIV-positive patients were age, history of pneumonia, lymphoma, presence of a percutaneous device within the past 12 months, history of household members hospitalized more than two times within the past 12 months, and a most recent CD4 count less than 200.
  
  
  CONCLUSIONS
  This study highlights that a proportion of MRSA carriers would have been undetected without multiple-site screening cultures. This study could shed insight into identifying patients at risk of MRSA colonization upon hospital visit and this may suggest that a risk factor-based approach for MRSA surveillance focusing on high risk populations could be considered.
authors.affiliation: Department of Clinical Epidemiology, Communicable Disease Centre, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore. mar_kyaw_win@ttsh.com.sg.
authors.forename: Win Mar
authors.initials: WM
authors.lastname: Kyaw
authors.forename: Linda Kay
authors.initials: LK
authors.lastname: Lee
authors.forename: Wong Chia
authors.initials: WC
authors.lastname: Siong
authors.forename: Angela Chow Li
authors.initials: AC
authors.lastname: Ping
authors.forename: Brenda
authors.initials: B
authors.lastname: Ang
authors.forename: Yee Sin
authors.initials: YS
authors.lastname: Leo