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Community-Associated Methicillin-Resistant Staphylococcus aureus Skin and Soft-Tissue Infection in HIV-Infected Patients

Department of Medicine, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island, ttonytrinh{at}gmail.com

William R. Short, MD

Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania

Leonard A. Mermel, DO, ScM

Department of Medicine, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, Rhode Island

Background. Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as the most common cause of skin and soft tissue infections (SSTIs). Methods. Retrospective chart review of 43 adult HIV-infected patients with CA-MRSA SSTI was conducted. Results. Antibiotic susceptibility was as follows: vancomycin (100%), rifampin (100%), gentamicin (97.7%), tetracycline (96.5%), trimethoprim-sulfamethoxazole (95.2%), clindamycin (89.5%), levofloxacin (66.7%), and erythromycin (6.9%). At SSTI presentation, 58.5% of patients had CD4 counts greater than 200 cells/uL, 82.9% had a viral load (VL) below 100 000 log copies/mL, 6 of whom had undetectable VL. All 43 patients received empiric antibiotic therapy. Additionally, 34 patients underwent incision and drainage (I&D). For the 37 patients with follow-up data available at 4 weeks, 30 of the infections were resolved/resolving and 7 had no improvement or worsened. Conclusion. A majority of our patients with CA-MRSA SSTI did not have immunological/virological markers consistent with severe HIV/AIDS disease at time of presentation.

Key Words: MRSA • SSTI • HIV

This version was published on May 1, 2009

Journal of the International Association of Physicians in AIDS Care (JIAPAC), Vol. 8, No. 3, 176-180 (2009)
DOI: 10.1177/1545109709335750


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