Living Conditions as a Driving Factor in Persistent Methicillin-resistant Staphylococcus aureus Colonization Among HIV-infected Youth.
| Autor: | Vieira MT; From the *School of Medicine, Graduate Program in Medical Science, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; †School of Public Health, University of California, Berkeley, Berkeley, California; ‡Laboratory of Molecular Epidemiology and Biotechnology, Rodolfo Albino University Laboratory, Rio de Janeiro, Brazil; §Graduate Program in Pathology, ¶Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; ‖Department of Infectious Diseases, Servidores do Estado Federal Hospital; and **Institute of Mathematics and Statistics, Graduate Program in Medical Science, Rio de Janeiro, Brazil., Marlow MA, Aguiar-Alves F, Pinheiro MG, Freitas Alves Mde F, Santos Cruz ML, Saavedra Gaspar MC, Rocha R, Velarde LG, Araújo Cardoso CA |
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| Jazyk: | angličtina |
| Zdroj: | The Pediatric infectious disease journal [Pediatr Infect Dis J] 2016 Oct; Vol. 35 (10), pp. 1126-31. |
| DOI: | 10.1097/INF.0000000000001246 |
| Abstrakt: | Background: Methicillin-resistant Staphylococcus aureus (MRSA) colonization has been linked to HIV-related sexual and social behaviors. MRSA risk factors may be different for HIV-infected children, adolescents and young adults. We investigated the association of MRSA colonization, persistent colonization and genotypes with potential risk factors among HIV-infected youth. Methods: For this case-control study, patients 24 years of age or younger attending 2 HIV reference centers were recruited from February to August 2012 and followed for 1 year. Nasal swabs were collected at enrollment and every 3 months. MRSA clones were characterized by staphylococcal chromosomal cassette mec typing, spa typing and multilocus sequence typing. We compared MRSA colonization and persistent colonization with patient demographic and clinical characteristics. Results: Among 117 participants, MRSA colonization frequency (calculated for each collection based on the number of positive cultures per patient) was 12.8% at the first collection. The average MRSA colonization frequency was 10.4%. Our results showed 11.1% were persistent carriers (subjects with more than 1 positive culture in at least 3). Crowding was the only factor associated with MRSA colonization (P = 0.018). Persistent carriers had significantly higher (4.2 times) odds of living in a crowded household (95% confidence interval-1.1-16.2). We observed high genetic diversity among MRSA isolates, with t002/ST5 and t318/ST30 being the most frequent. Conclusions: MRSA colonization among HIV-infected youth is more closely related to living in a low-income or slum community than to HIV-related clinical factors. High genetic MRSA isolate diversity in our population suggests frequent transmission. |
| Databáze: | MEDLINE |
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