1. Observational study of skin and soft-tissue Staphylococcus aureus infection in patients infected with HIV-1 and epidemics of Panton–Valentine leucocidin-positive community-acquired MRSA infection in Osaka, Japan
- Author
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Takuma Shirasaka, Yasuharu Nishida, Daisuke Sakanashi, Takahiro Taguri, Tomoko Uehira, Hiroshige Mikamo, Yusuke Koizumi, Mami Takeda, Dai Watanabe, Kazuyuki Hirota, Kentaro Ozawa, and Takashi Ueji
- Subjects
Male ,Methicillin-Resistant Staphylococcus aureus ,0301 basic medicine ,Microbiology (medical) ,Staphylococcus aureus ,medicine.medical_specialty ,030106 microbiology ,Human immunodeficiency virus (HIV) ,Exotoxins ,medicine.disease_cause ,Sexual and Gender Minorities ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Leukocidins ,Internal medicine ,Epidemiology ,medicine ,Humans ,Pharmacology (medical) ,In patient ,030212 general & internal medicine ,Homosexuality, Male ,Epidemics ,Retrospective Studies ,business.industry ,SCCmec ,Soft tissue ,Staphylococcal Infections ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,Community-Acquired Infections ,Infectious Diseases ,Panton valentine leucocidin ,HIV-1 ,Observational study ,business - Abstract
In patients infected with human immunodeficiency virus (HIV)-1 at our hospital, we observed increases in skin and soft-tissue infections (SSTIs) by community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Therefore, we analyzed factors related to CA-MRSA infection and performed a molecular epidemiological investigation.HIV-1-infected patients were diagnosed with SSTIs related to S. aureus between 2007 and 2017, and MRSA was classified into community and hospital-acquired types according to published criteria. Information was collected retrospectively from clinical records, and multivariate analysis by logistic regression was performed concerning factors related to CA-MRSA infection. We evaluated the staphylococcal cassette chromosome mec (SCCmec) type, multilocus sequence type, and the presence of genes encoding Panton-Valentine leucocidin (PVL) in 27 MRSA samples isolated during and after 2015.We found 218 episodes of SSTIs in 169 patients, and among initial episodes of SSTIs, the MRSA ratio was higher from 2015 to 2017 relative to that from 2007 to 2014 (88% vs. 44%; p 0.0001). Multivariate analysis showed that in men having sex with men [MSM; odds ratio (OR): 13] and exhibiting onset during and after 2015 (OR: 5.4), CD4These data describe an increased prevalence of SSTIs due to PVL-positive ST8-MRSA-IV, not previously considered epidemic in Japan, in MSM infected with HIV-1 in Osaka, Japan.
- Published
- 2020