The most significant findings are the unexpected association between MRSA carriage and HIV infection and identification of mupirocin-resistant strains in this small controlled study, told senior investigator Dr. Barry N. Kreiswirth.
Dr. Kreiswirth of the Public Health Research Institute Tuberculosis Center, Newark, New Jersey, and team reported these findings after investigating 107 HIV-1 patients with no evidence of immune suppression and 52 controls. The study included all men who had sex with men.
The study found that cumulative prevalence of MRSA carriage in HIV group (16.8%) was significantly higher than in controls (5.8%). Moreover, all of the 10 MRSA skin and soft tissue infections observed were in HIV patients. They were all of the same strain as the colonizing pathogens.
Moreover, 8 (38.1%) of the 21 MRSA isolates analyzed were mupirocin resistant, which, say the investigators, is a considerably higher percentage than the 7%-15% seen in other reports.
Although the study was small, the team point out that the comparison group of individuals not infected with HIV-1 was recruited from the same source population as the HIV-1-infected individuals, and this should mitigate potential bias related to the small sample size.
The results raise the concern that HIV-infected persons may be at an increased risk for infection and that targeted carriage surveillance for HIV-infected patients may be prudent, concluded Dr. Kreiswirth.
