The incidence of and risk factors for MRSA bacteraemia in an HIV-infected cohort in the HAART era

M. D. Burkey, L. E. Wilson, R. D. Moore, G. M. Lucas, J. Francis, K. A. Gebo

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To define the incidence and risk factors for methicillin resistant Staphylococcus aureus (MRSA) bacteraemia in an HIV-infected population. Methods: From January 1, 2000 to December 31, 2004, we conducted a retrospective cohort study. We identified all cases of Staphylococcus aureus bacteraemia (SAB), including MRSA, among patients enrolled in the Johns Hopkins Hospital out-patient HIV clinic. A conditional logistic regression model was used to identify risk factors for MRSA bacteraemia compared with methicillin-sensitive SAB and no bacteraemia in unmatched (1:1) and matched (1:4) nested case-control analyses, respectively. Results: Of 4607 patients followed for a total of 11020 person-years (PY) of follow-up, 216 episodes of SAB occurred (incidence: 19.6 cases per 1000 PY), including 94 cases (43.5%) which were methicillin-resistant. The incidence of MRSA bacteraemia increased from 5.3 per 1000 PY in 2000-2001 to 11.9 per 1000 PY in 2003-2004 (P = 0.001). Multivariate analysis demonstrated that independent predictors of MRSA bacteraemia (vs. no bacteraemia) were injection drug use (IDU), end-stage renal disease (ESRD) and CD4 count <200 cells/μL. Conclusions: MRSA bacteraemia was an increasingly common diagnosis in our HIV-infected cohort, especially in patients with history of IDU, low CD4 cell count and ESRD.

Original languageEnglish (US)
Pages (from-to)858-862
Number of pages5
JournalHIV Medicine
Volume9
Issue number10
DOIs
StatePublished - Nov 2008

Keywords

  • Bacteremia
  • HIV
  • MRSA
  • Sepsis
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

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