Increasing rates of community-acquired methicillin-resistant Staphylococcus aureus infections among HIV-infected persons

2007 ◽  
Vol 18 (8) ◽  
pp. 521-526 ◽  
Author(s):  
Nancy F Crum-Cianflone ◽  
Alina A Burgi ◽  
Braden R Hale
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
General Population ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incidence Rates ◽  
Hiv Viral Load ◽  
Syphilis Infection ◽  
Methicillin Resistant ◽  
History Of ◽  
Mrsa Infection

Community-acquired (CA) methicillin-resistant Staphylococcus aureus (MRSA) rates have rapidly increased in the general population; however, little data on recent incidence rates and risk factors of CA-MRSA infections among HIV patients appear in the literature. A retrospective study was conducted from 1993 through 2005 among patients at a large HIV clinic. Trends in CA-MRSA infection incidence rates, clinical characteristics and risk factors for CA-MRSA were evaluated. Seven percent of our cohort developed a CA-MRSA infection during the study period. The rate of CA-MRSA infections among HIV-infected population significantly increased since 2003, with an incidence of 40.3 cases/1000 person-years in 2005, which was 18-fold higher than the general population served at our facility. In all, 90% of infections were skin/soft tissue infections with a predilection for buttock or scrotal abscess formation; 21% of patients experienced a recurrent infection. Risk factors included a low CD4 count at the time of infection (odds ratio [OR] per 100 CD4 cells 0.84, P = 0.03), high maximum log10 HIV viral load (OR 4.54, P<0.001), recent use of β-lactam antibiotics (OR 6.0 for receipt of two prescriptions, P<0.001) and a history of syphilis (OR 4.55, P = 0.01). No patient receiving trimethoprim-sulfamethoxazole prophylaxis developed a CA-MRSA infection. Over the study period, CA-MRSA accounted for an increasing percentage of positive wound cultures and Staphylococcus aureus isolates, 37% and 65%, respectively, during 2005. In conclusion, CA-MRSA infections have rapidly increased among HIV-infected patients, a group which has a higher rate of these infections than the general population. Risk factors for CA-MRSA among HIV-infected patients include low current CD4 cell count, recent β-lactam antibiotic use and potentially high-risk sexual activity as demonstrated by a history of syphilis infection.

scholarly journals 1230. Epidemiology and Risk Factors for Recurrent Invasive Methicillin-Resistant Staphylococcus aureus Infection: nine US States, 2006–2013

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S373-S374
Author(s):  
Ian Kracalik ◽  
Kelly Jackson ◽  
Joelle Nadle ◽  
Wendy Bamberg ◽  
Susan Petit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Infection Type ◽  
The United States ◽  
Emerging Infections ◽  
Methicillin Resistant ◽  
Initial Infection ◽  
Joint Infections ◽  
Mrsa Infection

Abstract Background Methicillin-resistant Staphylococcus aureus (MRSA) causes &gt;70,000 invasive infections annually in the United States, and recurrent infections pose a major clinical challenge. We examined risk factors for recurrent MRSA infections. Methods We identified patients with an initial invasive MRSA infection (isolation from a normally sterile body site) from 2006 to 2013, through active, population-based surveillance in selected counties in nine states through the Emerging Infections Program. Recurrence was defined as invasive MRSA isolation &gt;30 days after initial isolation. We used logistic regression with backwards selection to evaluate adjusted odds ratios (aOR) associated with recurrence within 180 days, prior healthcare exposures, and initial infection type, controlling for patient demographics and comorbidities. Results Among 24,478 patients with invasive MRSA, 3,976 (16%) experienced a recurrence, including 61% (2,438) within 180 days. Risk factors for recurrence were: injection drug use (IDU) (aOR; 1.38, 95% confidence interval [CI]: 1.15–1.65), central venous catheters (aOR; 1.35, 95% CI: 1.22–1.51), dialysis (aOR; 2.00, 95% CI: 1.74–2.31), and history of MRSA colonization (aOR; 1.35, 95% CI: 1.22–1.51) (figure). Recurrence was more likely for bloodstream infections (BSI) without another infection (aOR; 2.08, 95% CI: 1.74–2.48), endocarditis (aOR; 1.46, 95% CI: 1.16–1.55), and bone/joint infections (aOR; 1.38, 95% CI: 1.20–1.59), and less likely for pneumonia (aOR: 0.75, 95% CI: 0.64–0.89), compared with other initial infection types. When assessed separately, the presence of a secondary BSI with another infection increased the odds of recurrence over that infection without a BSI (aOR: 1.96, 95% CI: 1.68–2.30). Conclusion Approximately one in six persons with invasive MRSA infection had recurrence. We identified potential opportunities to prevent recurrence through infection control (e.g., management and early removal of central catheters). Other possible areas for preventing recurrence include improving the management of patients with BSI and bone/joint infections (including both during and after antibiotic treatment) and mitigating risk of infection from IDU. Disclosures All authors: No reported disclosures.

Incidence and risk factors for community-associated methicillin-resistant Staphylococcus aureus in New York City, 2006–2012

2015 ◽  
Vol 144 (5) ◽  
pp. 1014-1017 ◽  
Author(s):  
P. BAKER ◽  
B. COHEN ◽  
J. LIU ◽  
E. LARSON
Keyword(s):  
Risk Factors ◽  
New York ◽  
Staphylococcus Aureus ◽  
New York City ◽  
Logistic Regression ◽  
York City ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Factors Associated ◽  
History Of

SUMMARYThis study aims to describe changes in incidence and risk factors for community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) infections upon admission to two New York City hospitals from 2006 to 2012. We examined the first hospitalization for adult patients using electronic health record and administrative data and determined the annual incidence/1000 admissions of total S. aureus, total MRSA, and CA-MRSA (within 48 h of admission) in clinical specimens over the study period. Logistic regression was used to identify factors associated with CA-MRSA in 2006 and 2012. In 137 350 admissions, the incidence of S. aureus, MRSA, and CA-MRSA/1000 admissions were 15·6, 7·0, and 3·5, respectively. The total S. aureus and MRSA isolations decreased significantly over the study period (27% and 25%, respectively) while CA-MRSA incidence was unchanged. CA-MRSA increased as a proportion of all MRSA between 2006 (46%) and 2012 (62%), and was most frequently isolated from respiratory (1·5/1000) and blood (0·7/1000) cultures. Logistic regression analysis of factors associated with isolation of CA-MRSA showed that age ⩾65 years [odds ratio (OR) 2·3, 95% confidence interval (CI) 1·2–4·5], male gender (OR 1·8, 95% CI 1·2–2·8) and history of renal failure (OR 2·6, 95% CI 1·6–4·2) were significant predictors of infection in 2006. No predictors were identified in 2012.

Trends in annual incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in HIV-infected and HIV-uninfected patients

2013 ◽  
Vol 141 (11) ◽  
pp. 2392-2402 ◽  
Author(s):  
G. N. DELORENZE ◽  
M. A. HORBERG ◽  
M. J. SILVERBERG ◽  
A. TSAI ◽  
C. P. QUESENBERRY ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Health Plan ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incidence Rates ◽  
Infected Group ◽  
Rapid Rise ◽  
Infection Rates ◽  
Methicillin Resistant ◽  
Mrsa Infection

SUMMARYWe describe trends in incidence rates of methicillin-resistant Staphylococcus aureus (MRSA) in HIV-infected and HIV-uninfected patients enrolled in a large northern California Health Plan, and the ratio of MRSA to methicillin-susceptible S. aureus (MSSA) case counts. Between 1995 and 2010, 1549 MRSA infections were diagnosed in 14060 HIV-infected patients (11·0%) compared to 89546 MRSA infections in 6597396 HIV-uninfected patients (1·4%) (P = 0·00). A steady rise in MRSA infection rates began in 1995 in HIV-uninfected patients, peaking at 396·5 infections/100000 person-years in 2007. A more rapid rise in MRSA infection rates occurred in the HIV-infected group after 2000, peaking at 3592·8 infections/100000 in 2005. A declining trend in MRSA rates may have begun in 2008–2009. Comparing the ratio of MRSA to MSSA case counts, we observed that HIV-infected patients shouldered a greater burden of MRSA infection during most years of study follow-up compared to HIV-uninfected patients.

Risk factors for methicillin-resistant staphylococcus aureus (MRSA) infection in a Japanese geriatric hospital

Public Health ◽  
1997 ◽  
Vol 111 (3) ◽  
pp. 187-190 ◽  
Author(s):  
M Washio ◽  
T Mizoue ◽  
T Kajioka ◽  
T Yoshimitsu ◽  
M Okayama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Methicillin Resistant ◽  
Geriatric Hospital ◽  
Mrsa Infection

scholarly journals The Prevalence, Risk, and Management of Methicillin-Resistant Staphylococcus aureus Infection in Diverse Populations across Canada: A Systematic Review

Pathogens ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 393 ◽  
Author(s):  
Elena Mitevska ◽  
Britney Wong ◽  
Bas G. J. Surewaard ◽  
Craig N. Jenne
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Infection Control ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Control Measures ◽  
Diverse Populations ◽  
Methicillin Resistant ◽  
Infection Control Measures ◽  
Mrsa Infection

Methicillin-resistant Staphylococcus aureus (MRSA) first emerged after methicillin was introduced to combat penicillin resistance, and its prevalence in Canada has increased since the first MRSA outbreak in the early 1980s. We reviewed the existing literature on MRSA prevalence in Canada over time and in diverse populations across the country. MRSA prevalence increased steadily in the 1990s and 2000s and remains a public health concern in Canada, especially among vulnerable populations, such as rural, remote, and Indigenous communities. Antibiotic resistance patterns and risk factors for MRSA infection were also reported. All studies reported high susceptibility (>85%) to trimethoprim-sulfamethoxazole, with no significant resistance reported for vancomycin, linezolid, or rifampin. While MRSA continues to have susceptibility to several antibiotics, the high and sometimes variable resistance rates to other drugs underscores the importance of antimicrobial stewardship. Risk factors for high MRSA infection rates related to infection control measures, low socioeconomic status, and personal demographic characteristics were also reported. Additional surveillance, infection control measures, enhanced anti-microbial stewardship, and community education programs are necessary to decrease MRSA prevalence and minimize the public health risk posed by this pathogen.

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