Protection Against Colonization in People Living With Human Immunodeficiency Virus in an Inner-City Outpatient Population: A Cross-Sectional Study.

BACKGROUND

People living with human immunodeficiency virus (PLWH) have been disproportionally affected by methicillin-resistant (MRSA) colonization and infection, in particular by clones USA300 and USA500. However, the contribution of epidemiological, bacterial, and immunological risk factors to the excess of in PLWH remain incompletely understood.

METHODS

In this cross-sectional study, we determined the prevalence and molecular epidemiology of colonization in 93 PLWH attending an urban human immunodeficiency virus (HIV) clinic. Participants completed a structured interview assessing demographic information and risk factors for MRSA. Swabs were obtained from the nose, throat, and groin and cultured for and .

RESULTS

Most participants had well controlled HIV infection (89, 96% CD4 >200). Thirty-six (39%) individuals were colonized with at 1 or more body sites, including 6 (6%) with MRSA. Regular gym use was a risk factor for but not MRSA carriage. In contrast, was present in almost all individuals (n = 84, 90%), predominantly in the nares (n = 66, 71%). Using generalized estimating equation models, we observed that the odds of colonization were significantly and drastically reduced when was detected ( = .0001). After controlling for site, gender, and age, we identified that the odds of colonization were 80% less if was present (adjusted odds ratio, 0.20; 95% confidence interval, .09-.45; < .0001).

CONCLUSIONS

Taken together, we observed a lower prevalence of and MRSA colonization than has been previously reported in PLWH. In this cohort, colonization with was protective against colonization.