Premium
The incidence of and risk factors for MRSA bacteraemia in an HIV‐infected cohort in the HAART era *
Author(s) -
Burkey MD,
Wilson LE,
Moore RD,
Lucas GM,
Francis J,
Gebo KA
Publication year - 2008
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2008.00629.x
Subject(s) - medicine , human immunodeficiency virus (hiv) , incidence (geometry) , cohort , bacteremia , cohort study , intensive care medicine , virology , microbiology and biotechnology , antibiotics , physics , optics , biology
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 11 020 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.