Methicillin-Resistant Staphylococcus aureus Infections in Human Immunodeficiency Virus-Infected Children and Adolescents
Background. Methicillin-resistant Staphylococcus aureus (MRSA) infection incidence has increased in healthy US children. Our objective was to evaluate MRSA incidence and correlates in HIV-infected youth. Methods. The CDC-sponsored LEGACY study is a US multicenter chart abstraction study of HIV-infec...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2012/627974 |
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| author | George K. Siberry Toni Frederick Patricia Emmanuel Mary E. Paul Beverly Bohannon Travis Wheeling Theresa Barton Mobeen H. Rathore Kenneth L. Dominguez |
| author_facet | George K. Siberry Toni Frederick Patricia Emmanuel Mary E. Paul Beverly Bohannon Travis Wheeling Theresa Barton Mobeen H. Rathore Kenneth L. Dominguez |
| author_sort | George K. Siberry |
| collection | DOAJ |
| description | Background. Methicillin-resistant Staphylococcus aureus (MRSA) infection incidence has increased in healthy US children. Our objective was to evaluate MRSA incidence and correlates in HIV-infected youth. Methods. The CDC-sponsored LEGACY study is a US multicenter chart abstraction study of HIV-infected youth. We identified MRSA infections among participants with ≥1 visit during 2006. We used bivariate and multivariable analyses to compare sociodemographic and HIV clinical factors between MRSA cases and noncases. Results. Fourteen MRSA infections (1 invasive, 12 soft tissue, 1 indeterminate) occurred among 1,813 subjects (11.1 infections/1,000 patient-years (PY), 95% CI: 11.06–11.14). Most (86%) isolates were clindamycin susceptible. Compared with noncases, MRSA cases were more likely older (17 versus 14 years), black (100% versus 69%), behaviorally HIV infected (43% versus 17%), and in Maryland (43% versus 7%) and had viral loads (VL) >1000 copies/mL (86% versus 51%) and lower mean CD4% (18% versus 27%) (all P<0.05). In multivariate analysis, independent risk factors were Maryland care site (adjusted odds ratio (aOR) = 9.0), VL >1000 copies/mL (aOR = 5.9), and black race (aOR undefined). Conclusions. MRSA occurred at a rate of 11.1 infections/1,000 PY in HIV-infected youth but invasive disease was uncommon. Geographic location, black race, and increased VL, but not immunosuppression, were independently associated with MRSA risk. |
| format | Article |
| id | doaj-art-33fc823da8584ead945ebbe6a83e6519 |
| institution | Kabale University |
| issn | 2090-1240 2090-1259 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | AIDS Research and Treatment |
| spelling | doaj-art-33fc823da8584ead945ebbe6a83e65192025-02-03T01:01:04ZengWileyAIDS Research and Treatment2090-12402090-12592012-01-01201210.1155/2012/627974627974Methicillin-Resistant Staphylococcus aureus Infections in Human Immunodeficiency Virus-Infected Children and AdolescentsGeorge K. Siberry0Toni Frederick1Patricia Emmanuel2Mary E. Paul3Beverly Bohannon4Travis Wheeling5Theresa Barton6Mobeen H. Rathore7Kenneth L. Dominguez8Pediatric, Adolescent & Maternal AIDS (PAMA) Branch, Eunice Kennedy Shriver National Institute of Child Health & Human Development, National Institutes of Health, Bethesda, MD 20892-7510, USAMaternal, Child, Adolescent/Adult Center for Infectious Diseases and Virology, University of Southern California, Los Angeles, CA 90033, USADepartment of Pediatrics, University of South Florida College of Medicine, Tampa, FL 33606, USADepartment of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USADivision of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USANorthrop Grumman Inc., Atlanta, GA 30345, USADepartment of Pediatric Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, TX 75390, USADepartment of Pediatric Infectious Diseases and Immunology, University of Florida and Wolfson Children’s Hospital, and University of Florida Center for HIV/AIDS Research, Education and Service (UF CARES), Jacksonville, FL 32209, USADivision of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USABackground. Methicillin-resistant Staphylococcus aureus (MRSA) infection incidence has increased in healthy US children. Our objective was to evaluate MRSA incidence and correlates in HIV-infected youth. Methods. The CDC-sponsored LEGACY study is a US multicenter chart abstraction study of HIV-infected youth. We identified MRSA infections among participants with ≥1 visit during 2006. We used bivariate and multivariable analyses to compare sociodemographic and HIV clinical factors between MRSA cases and noncases. Results. Fourteen MRSA infections (1 invasive, 12 soft tissue, 1 indeterminate) occurred among 1,813 subjects (11.1 infections/1,000 patient-years (PY), 95% CI: 11.06–11.14). Most (86%) isolates were clindamycin susceptible. Compared with noncases, MRSA cases were more likely older (17 versus 14 years), black (100% versus 69%), behaviorally HIV infected (43% versus 17%), and in Maryland (43% versus 7%) and had viral loads (VL) >1000 copies/mL (86% versus 51%) and lower mean CD4% (18% versus 27%) (all P<0.05). In multivariate analysis, independent risk factors were Maryland care site (adjusted odds ratio (aOR) = 9.0), VL >1000 copies/mL (aOR = 5.9), and black race (aOR undefined). Conclusions. MRSA occurred at a rate of 11.1 infections/1,000 PY in HIV-infected youth but invasive disease was uncommon. Geographic location, black race, and increased VL, but not immunosuppression, were independently associated with MRSA risk.http://dx.doi.org/10.1155/2012/627974 |
| spellingShingle | George K. Siberry Toni Frederick Patricia Emmanuel Mary E. Paul Beverly Bohannon Travis Wheeling Theresa Barton Mobeen H. Rathore Kenneth L. Dominguez Methicillin-Resistant Staphylococcus aureus Infections in Human Immunodeficiency Virus-Infected Children and Adolescents AIDS Research and Treatment |
| title | Methicillin-Resistant Staphylococcus aureus Infections in Human Immunodeficiency Virus-Infected Children and Adolescents |
| title_full | Methicillin-Resistant Staphylococcus aureus Infections in Human Immunodeficiency Virus-Infected Children and Adolescents |
| title_fullStr | Methicillin-Resistant Staphylococcus aureus Infections in Human Immunodeficiency Virus-Infected Children and Adolescents |
| title_full_unstemmed | Methicillin-Resistant Staphylococcus aureus Infections in Human Immunodeficiency Virus-Infected Children and Adolescents |
| title_short | Methicillin-Resistant Staphylococcus aureus Infections in Human Immunodeficiency Virus-Infected Children and Adolescents |
| title_sort | methicillin resistant staphylococcus aureus infections in human immunodeficiency virus infected children and adolescents |
| url | http://dx.doi.org/10.1155/2012/627974 |
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