Methicillin-resistant Staphylococcus aureus nasal colonization among HIV-infected patients in Taiwan: Prevalence, molecular characteristics and associated factors with nasal carriage

Yi Yu Hsu, David Wu, Chien Ching Hung, Shie Shian Huang, Fang Hsueh Yuan, Ming Hsun Lee, Ching Tai Huang, Shian Sen Shie, Po Yen Huang, Chien Chang Yang, Chun Wen Cheng, Hsieh Shong Leu, Ting Shu Wu, Yhu Chering Huang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

9 Scopus citations

Abstract

Background: To evaluate nasal carriage, antibiotic susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA), as well as the risk factors of MRSA colonization, in human immunodeficiency virus (HIV)-infected patients in northern Taiwan. Methods: From September 2014 to November 2015, HIV-infected patients seeking outpatient care at four hospitals were eligible for this study. A nasal specimen was obtained from each subject for the detection of S. aureus and a questionnaire was completed by each subject. MRSA isolates once identified were characterized. Results: Of 553 patients surveyed, methicillin-susceptible S. aureus (MSSA) was detected in 119 subjects (21.5%) and MRSA in 19 subjects (3.4%). Female gender, injection drug use, smoking, hepatitis C virus carrier, cancer and antibiotic use within 1 year were positively associated with MRSA colonization. By multivariate analysis, only cancer (adjust odds ratio (aOR) 7.78, [95% confidence interval (CI), 1.909-31.731]) and antibiotic use within 1 year (aOR 3.89, [95% CI, 1.219-12.433]) were significantly associated with MRSA colonization. Ten isolates were characterized as sequence type (ST) 59/staphylococcal chromosome cassette (SCC) IV or VT, endemic community strains in Taiwan, four isolates as ST 8/SCCmec IV (USA 300) and one isolate as ST 239/SCCmec IIIA, a hospital strain. All the community-associated MRSA isolates were susceptible to trimethoprim-sulfamethoxazole (TMP-SMX). Conclusions: Nasal MRSA carriage in HIV-infected patients seeking outpatient care was low (3.4%) in northern Taiwan. Most of the colonizing isolates were genetically endemic community strains and exhibited high susceptibility to TMP-SMX and fluoroquinolones. Cancer and antibiotic use within 1 year were associated with MRSA colonization.

Original languageEnglish
Article number254
JournalBMC Infectious Diseases
Volume20
Issue number1
DOIs
StatePublished - 30 03 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 The Author(s).

Keywords

  • Antibiotic use
  • Injection drug use
  • Injection drug user
  • Molecular typing
  • Nasal carriage

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