Colonization in Groin Linked to MRSA Infection in Adults With HIV

Researchers report that HIV-infected adults are more likely to have methicillin-resistant Staphylococcus aureus (MRSA) infections if the patients have a history of MRSA colonization in the groin or they have had a prior MRSA infection acquired from the community or a health care setting. MRSA colonization is more prevalent among HIV-infected people than among the general U.S. population.

To determine the MRSA risk related to colonization, researchers recruited 600 patients from the Atlanta VA Medical Center. The participants provided a baseline specimen from the anterior nares and groin and supplied two additional specimens at subsequent clinic visits over the next two years. The study aimed to identify participants with MRSA colonization in the nares and the groin and to diagnose MRSA infections.

Initial specimens revealed MRSA colonization in 79 study participants (41 percent in the nares only, 21 percent in the groin only, and 38 percent in both the nares and groin). At the six-month mark, 66 participants had MRSA colonizations; at the twelve-month mark, 62 participants had MRSA colonizations.

During two years of follow-up, 25 study participants developed 29 MRSA infections. Twelve of those who developed MRSA infections during the study had MRSA colonization in the groin only or in the groin and nares at the baseline measurement. The most common MRSA infections during the study were skin, tissue, pneumonia, and bacteremia, and tests found the clinical isolate USA300 in 64 percent of the MRSA infections.

Study authors recommended improved "hygienic practices and decolonization treatment" to eliminate or reduce MRSA colonization and to prevent MRSA infections among HIV-infected adults.

The full report, "Methicillin-Resistant Staphylococcus Aureus Colonization of the Groin and Risk for Clinical Infection among HIV-infected Adults" was published online March 13, 2013, in the journal Emerging Infectious Diseases at URL