Abstract
Background Methicillin-resistant coagulase-negative Staphylococci (MRCoNS) is regarded as the repository of mecA gene for methicillin-resistant Staphylococcus aureus (MRSA) and may develop methicillin-susceptible Staphylococcus aureus (MSSA) to MRSA. Therefore, we aimed to explore whether MRCoNS carriage is a risk factor of MRSA colonization. Phenotypic characteristics were performed to further assess the associations between MRSA and MRCoNS. Methods This cross-sectional study was conducted in Guangzhou, China. Participants completed a questionnaire and provided a nasal swab for further analysis. The risk factors of MRSA colonization were analyzed using nonconditional logistic regression models. The phenotypic characteristics between MRSA and MRCoNS were compared by Chi-square test. Results Among the 1001 HIV-infected patients, a total of 119 (11.89%) participants were positive for MRSA, and 34.45% (41/119) of all MRSA carriers were positive for MRCoNS. We found MRCoNS carriage was a protective factor of MRSA colonization (adjusted odds ratio = 0.59, 95% confidence interval: 0.38–0.91). A significant difference in the proportions of antibiotic resistance between MRSA and MRCoNS isolates was found except for penicillin, clindamycin, tetracycline, and teicoplanin. The main STs and CC types of MRSA isolates in this population were ST188 (15.1%) and CC59 (17.6%), respectively. Conclusions HIV-infected patients remain a highly vulnerable population for MRSA colonization. Though who carried MRCoNS is less likely to have MRSA colonization, similarity of some antibiotic resistance between MRSA and MRCoNS was found in this study. Regular surveillance on the colonization and antibiotic patterns of MRSA and MRCoNS is still necessary.
Highlights
As a common cause of severe infections, methicillin-resistant Staphylococcus aureus (MRSA) is still widespread in both health facilities and the community [1, 2]
A total of 1026 HIV-infected patients were eligible to participate and 1001 HIV-infected patients were enrolled in this study, including 845 males (84.42%) and 156 females (15.58%). e median age of this population was 35 years. e overall prevalence of S. aureus and MRSA colonization among HIV-infected patients was 25.2% (253/1001) and 11.9% (119/1001), respectively
Antibiotic Resistance. e proportions of antibiotic resistance between MRSA and Methicillin-resistant coagulase-negative Staphylococci (MRCoNS) isolates were significantly different except penicillin, clindamycin, tetracycline, and teicoplanin
Summary
As a common cause of severe infections, methicillin-resistant Staphylococcus aureus (MRSA) is still widespread in both health facilities and the community [1, 2]. Owing to the compromised immune system, HIV-infected patients are more vulnerable to MRSA colonization than other populations [3, 4]. The prevalence of MRSA isolates and the risk factors associated with MRSA colonization among HIV-infected patients has been reported in many countries and regions except mainland China. We hypothesize that there is a possible link between them on population’s level, which means MRCoNS carriage may be a potential risk factor of MRSA colonization in HIV-positive patients. Us, we design this crosssectional study to explore whether MRCoNS carriage is a risk factor of MRSA colonization in HIV-positive patients. HIV-infected patients remain a highly vulnerable population for MRSA colonization. Regular surveillance on the colonization and antibiotic patterns of MRSA and MRCoNS is still necessary
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