title: Methicillin-resistant Staphylococcus aureus in HIV patients: risk factors associated with colonization and/or infection and methods for characterization of isolates - a systematic review.
abstract: Staphylococcus aureus is an important cause of infections and HIV-infected individuals are frequently susceptible to this pathogen. The aim of this study was to perform a systematic review to identify both the risk factors associated with colonization/infection by methicillin-resistant S. aureus in HIV patients and the methods used for characterization of isolates. An electronic search of articles published between January 2001 and December 2013 was first conducted. Among 116 studies categorized as being at a quality level of A, B or C, only 9 studies were considered to have high methodological quality (level A). The majority of these studies were retrospective (4/9 studies). The risk factors associated with colonization/infection by S. aureus were use of antimicrobials (4/9 studies), previous hospitalization (4/9 studies) and low CD4+ T lymphocyte counts (<200 cells/μl) (3/9 studies). Culture in mannitol salt agar (3/9 studies) and the latex agglutination test (5/9 studies) were the main methods used for bacterial phenotypic identification. Genotypic profiles were accessed by pulsed-field gel electrophoresis (6/9 studies) and USA300 was the most prevalent lineage (5/9 studies). Most isolates were resistant to erythromycin (3/9 studies) and susceptible to vancomycin (4/9 studies). Ultimately, use of antimicrobials and previous hospitalization were the main risk factors for colonization/infection by methicillin-resistant S. aureus in HIV-infected individuals. However, the numbers of evaluated patients, the exclusion and inclusion criteria and the characterization of the S. aureus isolates were not uniform, which made it difficult to establish the characteristics associated with HIV patients who are colonized/infected by S. aureus.
authors.affiliation: Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), CAPES Foundation, Brasilia, DF, Brazil.
authors.forename: Dennis de Carvalho
authors.initials: Dde C
authors.lastname: Ferreira
authors.affiliation: Laboratório de Infecção Hospitalar, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Glaucilene Rodrigues da
authors.initials: GR
authors.lastname: Silva
authors.affiliation: Laboratório de Infecção Hospitalar, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Fernanda Sampaio
authors.initials: FS
authors.lastname: Cavalcante
authors.affiliation: Laboratório de Ecologia Microbiana Molecular, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Flavia Lima do
authors.initials: FL
authors.lastname: Carmo
authors.affiliation: Department of Oral Medicine, Dental School, Veiga de Almeida University, Rio de Janeiro, RJ, Brazil.
authors.forename: Leonardo Alexandre
authors.initials: LA
authors.lastname: Fernandes
authors.affiliation: Laboratório de Infecção Hospitalar, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Suelen
authors.initials: S
authors.lastname: Moreira
authors.affiliation: Department of Microbiology, STD sector, Federal Fluminense University, Niterói, RJ, Brazil.
authors.forename: Mauro Romero Leal
authors.initials: MR
authors.lastname: Passos
authors.affiliation: Laboratório de Microbiologia Oral, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Ana Paula Vieira
authors.initials: AP
authors.lastname: Colombo
authors.affiliation: Laboratório de Infecção Hospitalar, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Katia Regina Netto dos
authors.initials: KR
authors.lastname: Santos
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000382:microbiology*; D006801:Humans; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus / Q000254:growth & development / Q000302:isolation & purification*; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents