title: Methicillin-resistant Staphylococcus aureus colonization of the groin and risk for clinical infection among HIV-infected adults.
abstract: Data on the interaction between methicillin-resistant Staphylococcus aureus (MRSA) colonization and clinical infection are limited. During 2007-2008, we enrolled HIV-infected adults in Atlanta, Georgia, USA, in a prospective cohort study. Nares and groin swab specimens were cultured for S. aureus at enrollment and after 6 and 12 months. MRSA colonization was detected in 13%-15% of HIV-infected participants (n=600, 98% male) at baseline, 6 months, and 12 months. MRSA colonization was detected in the nares only (41%), groin only (21%), and at both sites (38%). Over a median of 2.1 years of follow-up, 29 MRSA clinical infections occurred in 25 participants. In multivariate analysis, MRSA clinical infection was significantly associated with MRSA colonization of the groin (adjusted risk ratio 4.8) and a history of MRSA infection (adjusted risk ratio 3.1). MRSA prevention strategies that can effectively prevent or eliminate groin colonization are likely necessary to reduce clinical infections in this population.
authors: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. pjpeters@cdc.gov
authors: Philip J
authors: PJ
authors: Peters
authors: John T
authors: JT
authors: Brooks
authors: Sigrid K
authors: SK
authors: McAllister
authors: Brandi
authors: B
authors: Limbago
authors: H Ken
authors: HK
authors: Lowery
authors: Gregory
authors: G
authors: Fosheim
authors: Jodie L
authors: JL
authors: Guest
authors: Rachel J
authors: RJ
authors: Gorwitz
authors: Monique
authors: M
authors: Bethea
authors: Jeffrey
authors: J
authors: Hageman
authors: Rondeen
authors: R
authors: Mindley
authors: Linda K
authors: LK
authors: McDougal
authors: David
authors: D
authors: Rimland
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019380:Anti-HIV Agents / Q000627:therapeutic use; D060085:Coinfection; D005845:Georgia; D006119:Groin / Q000382:microbiology*; D006678:HIV / Q000187:drug effects / Q000502:physiology*; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000502:physiology*; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D019380:Anti-HIV Agents
keywords: Georgia; HIV; MRSA; bacteria; colonization; methicillin-resistant Staphylococcus aureus; staphylococci; viruses
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