首页|Observational study of skin and soft-tissue Staphylococcus aureus infection in patients infected with HIV-1 and epidemics of PantoneValentine leucocidin-positive community-acquired MRSA infection in Osaka, Japan
Observational study of skin and soft-tissue Staphylococcus aureus infection in patients infected with HIV-1 and epidemics of PantoneValentine leucocidin-positive community-acquired MRSA infection in Osaka, Japan
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NSTL
Elsevier
Background: In patients infected with human immunodeficiency virus (HIV)-1 at our hospital, we observed increases in skin and soft-tissue infections (SSTIs) by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Therefore, we analyzed factors related to CA-MRSA infection and performed a molecular epidemiological investigation. Methods: HIV-1-infected patients were diagnosed with SSTIs related to S. aureus between 2007 and 2017, and MRSA was classified into community and hospital-acquired types according to published criteria. Information was collected retrospectively from clinical records, and multivariate analysis by logistic regression was performed concerning factors related to CA-MRSA infection. We evaluated the staphylococcal cassette chromosome mec (SCCmec) type, multilocus sequence type, and the presence of genes encoding Panton-Valentine leucocidin (PVL) in 27 MRSA samples isolated during and after 2015. Results: We found 218 episodes of SSTIs in 169 patients, and among initial episodes of SSTIs, the MRSA ratio was higher from 2015 to 2017 relative to that from 2007 to 2014 (88% vs. 44%; p < 0.0001). Multivariate analysis showed that in men having sex with men [MSM; odds ratio (OR): 13] and exhibiting onset during and after 2015 (OR: 5.4), CD4(+) cell count >= 200 cells/mu L (OR: 5.6) and the presence of lesions in the lower abdomen or buttocks (OR: 9.5) were independent factors related to CA-MRSA infection. Additionally, PVL+/ST8/SCCmec type IV MRSA was the predominant pathogen (22 cases; 81%). Conclusions: These data describe an increased prevalence of SSTIs due to PVL-positive ST8-MRSA-IV, not previously considered epidemic in Japan, in MSM infected with HIV-1 in Osaka, Japan. (C) 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
HIV-1 infectionSkin and softtissue infectionsCommunity-acquired methicillin-resistantStaphylococcus aureusPanton-valentine leucocidinMETHICILLIN-RESISTANTMOLECULAR CHARACTERIZATIONCOLONIZATIONSTRAINCARE
NSTL
Elsevier
