Skip to main content
×
Home

Risk Factors for Colonization or Infection Due to Methicillin-Resistant Staphylococcus Aureus in HIV-Positive Patients A Retrospective Case-Control Study

  • Michelle Onorato (a1), Michael J. Borucki (a1), Gwen Baillargeon (a1), David P. Paar (a1), Daniel H. Freeman (a1), C. Pat Cole (a1) and C. Glen Mayhall (a1)...
Abstract
Abstract Objective:

To determine the risk factors for colonization or infection with methicillin-resistant Staphylococcus aureus in human immunodeficiency virus (HIV)-infected patients.

Design:

Retrospective matched-pair case-control study.

Setting:

Continuity clinic and inpatient HIV service of a university medical center.

Population:

Patients with HIV infection from the general population of eastern and coastal Texas and from the Texas Department of Criminal Justice.

Data Collection:

Patient charts and the AIDS Care and Clinical Research Program Database were reviewed for the following: age, race, number of admissions, total hospital days, presence of a central venous catheter, serum albumin, total white blood cell count and absolute neutrophil count, invasive or surgical procedures, any cultures positive for S aureus, and a history of opportunistic illnesses, diabetes, or dermatologie diagnoses. Data also were collected on the administration of antibiotics, antiretroviral therapy, steroids, cancer chemotherapy, and subcutaneous medications.

Results:

In the univariate analysis, the presence of a central venous catheter, an underlying dermatologie disease, lower serum albumin, prior steroid therapy, and prior antibiotic therapy, particularly antistaphylococcal therapy or multiple courses of antibiotics, were associated with increased risk for colonization or infection with methicillin-resistant S aureus. Multivariate analysis yielded a model that included presence of a central venous catheter, underlying dermatologie disease, broad-spectrum antibiotic exposure, and number of hospital days as independent risk factors for colonization or infection with methicillin-resistant S aureus.

Conclusions:

In our HIV-infected patient population, prior hospitalization, exposure to broad-spectrum antibiotics, presence of a central venous catheter, and dermatologie disease were risk factors for acquisition of methicillin-resistant S aureus

Copyright
Corresponding author
Division of Infectious Diseases, University of Texas Medical Branch, 301 University Blvd, Galveston. TX 77555-0835
References
Hide All
1. Krumholz HM, Sande MA, Lo B. Community-acquired bacteremia in patients with acquired immunodeficiency syndrome: clinical presentation, bacteriology and outcome. Am J Med 1989;86:776779.
2. Raviglione MC, Battan R, Pablos-Mendez A, Aceves-Casillas P, Mullen MP, Taranta A. Infections associated with Hickman catheters in patients with the acquired immunodeficiency syndrome. Am J Med 1989;86:780786.
3. Skoutelis AT, Murphy RL, MacDonell KB, VonRoenn JH, Sterkel CD, Phair JP. Indwelling central venous catheter infections in patients with acquired immune deficiency syndrome. J Acquir Immune Defic Syndr Hum Retroviral 1990;3:335342.
4. Stroud L, Srivastava P, Culver D, Bisno A, Rimland D, Simberkoff M, et al. Nosocomial infections in HIV-infected patients: preliminary results from a multicenter surveillance system (1989-1995). Infect Control Hosp Epidemiol 1997;18:479485.
5. Knapp CC, Ludwig MD, Washington JA. Evaluation of differential inoculum disk diffusion method and Vitek GPS-SA card for detection of oxacillin-resistant staphylococci. J Clin Microbiol 1994;32:433436.
6. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128140.
7. Crossley K, Loesch D, Landesman B, Mead K, Chern M, Strate R. An outbreak of infections caused by strains of Staphylococcus aureus resistant to methicillin and aminoglycosides, I: clinical studies. J Infect Dis 1979;139:273279.
8. Peacock JE Jr, Marsik FJ, Wenzel RP. Methicillin-resistant Staphylococcus aureus: introduction and spread within a hospital. Ann Intern Med 1980;93:526532.
9. Ward TT, Winn RE, Hartstein AI, Sewell DL. Observations relating to an inter-hospital outbreak of methicillin-resistant Staphylococcus aureus: role of antimicrobial therapy in infection control. Infect Control 1981;2:453459.
10. Locksley RM, Cohen ML, Quinn TC, Tompkins LS, Coyle MB, Kirihara JM, et al. Multiply antibiotic-resistant Staphylococcus aureus: introduction, transmission, and evolution of nosocomial infection. Ann Intern Med 1982;97:317324.
11. Bitar CM, Mayhall CG, Lamb VA, Bradshaw TJ, Spadora AC, Dalton HP. Outbreak due to methicillin- and rifampin-resistant Staphylococcus aureus: epidemiology and eradication of the resistant strain from the hospital. Infect Control 1987;8:1523.
12. Rimland D. Nosocomial infections with methicillin and tobramycin resistant Staphylococcus aureus—implication of physiotherapy in hospital-wide dissemination. Am J Med Sci 1985;290:9197.
13. Arnow PM, Allyn PA, Nichols EM, Hill DL, Pezzlo M, Bartlett RH. Control of methicillin-resistant Staphylococcus aureus in a burn unit: role of nurse staffing. J Trauma 1982;22:954959.
14. Lentino JR, Hennein H, Krause S, Pappas S, Fuller G, Schaaf D, et al. A comparison of pneumonia caused by gentamicin, methicillin-resistant and gentamicin, methicillin-sensitive Staphylococcus aureus: epidemiologic and clinical studies. Infect Control 1985;6:267272.
15. Pujol M, Peña C, Panares R, Ayats J, Ariza J, Gudiol F. Risk factors for nosocomial bacteremia due to methicillin-resistant Staphylococcus aureus . Eur J Clin Microbiol Infect Dis 1994;13:96102.
16. Boyce JM, Landry M, Deetz TR, DuPont HL. Epidemiologic studies of an outbreak of nosocomial methicillin-resistant Staphylococcus aureus infections. Infect Control 1981;2:110116.
17. Leyden JJ, Marples RR, Kligman AM. Staphylococcus aureus in the lesions of atopic dermatitis. Br J Dermatol 1974;90:525530.
18. Bibel DJ, Greenberg JH, Cook JL. Staphylococcus aureus and the microbial ecology of atopic dermatitis. Can J Microbiol 1977;23:10621068.
19. Hanifin JM, Rogge JL. Staphylococcal infections in patients with atopic dermatitis. Arch Dermatol 1977;113:13831386.
20. Dahl MV. Staphylococcus aureus and atopic dermatitis. Arch Dermatol 1983;119:840846.
21. Aly R, Maibach HI, Mandel A. Bacterial flora in psoriasis. Br J Dermatol 1976;95:603606.
22. Marples RR, Heaton CL, Kligman AM. Staphylococcus aureus in psoriasis. Arch Dermatol 1973;107:568570.
23. Noble WC, Savin JA. Carriage of Staphylococcus aureus in psoriasis. BMJ 1968;1:417418.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Abstract views

Total abstract views: 87 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 21st November 2017. This data will be updated every 24 hours.