BACKGROUND: Human immunodeficiency virus (HIV)-infected individuals who are colonized with methicillin-resistant Staphylococcus aureus (MRSA) have increased risk for MRSA infection. We conducted a meta-analysis of published studies to estimate the prevalence of MRSA colonization in this population. METHODS: We performed a systematic literature review and meta-analysis. The PubMed and Embase databases were searched and studies reporting prevalence of MRSA colonization among HIV-infected individuals were included. RESULTS: Among 7940 citations, 32 studies reporting data on 6558 HIV-infected individuals were considered eligible for our meta-analysis. We found that 6.9% (95% confidence interval [CI], 4.8-9.3) of individuals with HIV infection are MRSA carriers, with the corresponding figure across North American studies being 8.8% (95% CI, 6.0-12.2). History of hospitalization during the previous 12 months was associated with a 3.1 times higher risk of MRSA colonization (risk ratio [RR], 3.11 [95% CI, 1.62-5.98]). Previous or current incarceration was also associated with a higher risk for carriage (RR, 1.77 [95% CI, 1.26-2.48]). Current antiretroviral therapy or use of trimethoprim-sulfamethoxazole did not impact the risk of MRSA carriage (RR, 1.02 [95% CI, .64-1.63] and 1.45 [95% CI, .69-3.03], respectively). Extranasal screening increased the detection of MRSA colonization by at least 31.6% (95% CI, 15.8-50.0). The added yield from groin screening was 19.3% (95% CI, 11.5-28.5), from perirectal screening 18.5% (95% CI, 7.4-33.2), and from throat cultures 17.5% (95% CI, 12.0-24). CONCLUSIONS: Individuals with HIV infection constitute a highly vulnerable population for MRSA colonization, and prior exposure to hospital or incarceration are significant factors. Nasal screening alone will underestimate the rate of colonization by at least one-third.
BACKGROUND: Human immunodeficiency virus (HIV)-infected individuals who are colonized with methicillin-resistant Staphylococcus aureus (MRSA) have increased risk for MRSA infection. We conducted a meta-analysis of published studies to estimate the prevalence of MRSA colonization in this population. METHODS: We performed a systematic literature review and meta-analysis. The PubMed and Embase databases were searched and studies reporting prevalence of MRSA colonization among HIV-infected individuals were included. RESULTS: Among 7940 citations, 32 studies reporting data on 6558 HIV-infected individuals were considered eligible for our meta-analysis. We found that 6.9% (95% confidence interval [CI], 4.8-9.3) of individuals with HIV infection are MRSA carriers, with the corresponding figure across North American studies being 8.8% (95% CI, 6.0-12.2). History of hospitalization during the previous 12 months was associated with a 3.1 times higher risk of MRSA colonization (risk ratio [RR], 3.11 [95% CI, 1.62-5.98]). Previous or current incarceration was also associated with a higher risk for carriage (RR, 1.77 [95% CI, 1.26-2.48]). Current antiretroviral therapy or use of trimethoprim-sulfamethoxazole did not impact the risk of MRSA carriage (RR, 1.02 [95% CI, .64-1.63] and 1.45 [95% CI, .69-3.03], respectively). Extranasal screening increased the detection of MRSA colonization by at least 31.6% (95% CI, 15.8-50.0). The added yield from groin screening was 19.3% (95% CI, 11.5-28.5), from perirectal screening 18.5% (95% CI, 7.4-33.2), and from throat cultures 17.5% (95% CI, 12.0-24). CONCLUSIONS: Individuals with HIV infection constitute a highly vulnerable population for MRSA colonization, and prior exposure to hospital or incarceration are significant factors. Nasal screening alone will underestimate the rate of colonization by at least one-third.
Authors: Margaret Sampson; Nicholas J Barrowman; David Moher; Terry P Klassen; Ba' Pham; Robert Platt; Philip D St John; Raymond Viola; Parminder Raina Journal: J Clin Epidemiol Date: 2003-10 Impact factor: 6.437
Authors: M H Nguyen; C A Kauffman; R P Goodman; C Squier; R D Arbeit; N Singh; M M Wagener; V L Yu Journal: Ann Intern Med Date: 1999-02-02 Impact factor: 25.391
Authors: Susan H Wootton; Kathryn Arnold; Holly A Hill; Sigrid McAllister; Marsha Ray; Molly Kellum; Madie LaMarre; Mary Ellen Lane; Jasmine Chaitram; Susan Lance-Parker; Matthew J Kuehnert Journal: Infect Control Hosp Epidemiol Date: 2004-05 Impact factor: 3.254
Authors: Philip J Peters; John T Brooks; Sigrid K McAllister; Brandi Limbago; H Ken Lowery; Gregory Fosheim; Jodie L Guest; Rachel J Gorwitz; Monique Bethea; Jeffrey Hageman; Rondeen Mindley; Linda K McDougal; David Rimland Journal: Emerg Infect Dis Date: 2013-04 Impact factor: 6.883
Authors: Jessica H Leibler; Casey León; Lena J P Cardoso; Jennifer C Morris; Nancy S Miller; Daniel D Nguyen; Jessie M Gaeta Journal: J Med Microbiol Date: 2017-08 Impact factor: 2.472
Authors: Michael J A Reid; Rebecca S B Fischer; Naledi Mannathoko; Charles Muthoga; Erin McHugh; Heather Essigmann; Eric L Brown; Andrew P Steenhoff Journal: Am J Trop Med Hyg Date: 2017-02-06 Impact factor: 2.345
Authors: Jason E Farley; Laura E Starbird; Jill Anderson; Nancy A Perrin; Kelly Lowensen; Tracy Ross; Karen C Carroll Journal: Am J Infect Control Date: 2017-07-03 Impact factor: 2.918
Authors: Sean B Sullivan; Suneel Kamath; Thomas H McConville; Brett T Gray; Franklin D Lowy; Peter G Gordon; Anne-Catrin Uhlemann Journal: Open Forum Infect Dis Date: 2016-12-20 Impact factor: 3.835
Authors: Nancy F Crum-Cianflone; Xun Wang; Amy Weintrob; Tahaniyat Lalani; Mary Bavaro; Jason F Okulicz; Katrin Mende; Michael Ellis; Brian K Agan Journal: Open Forum Infect Dis Date: 2015-03-06 Impact factor: 3.835
Authors: Netanya S Utay; Annelys Roque; J Katherina Timmer; David R Morcock; Claire DeLeage; Anoma Somasunderam; Amy C Weintrob; Brian K Agan; Jacob D Estes; Nancy F Crum-Cianflone; Daniel C Douek Journal: PLoS Pathog Date: 2016-04-19 Impact factor: 6.823