Staphylococcus aureus nasal colonization in HIV-seropositive and HIV-seronegative drug users

J Acquir Immune Defic Syndr Hum Retrovirol. 1997 Dec 1;16(4):301-6. doi: 10.1097/00042560-199712010-00012.

Abstract

Nasal colonization plays an important role in the pathogenesis of Staphylococcus aureus infections. To identify characteristics associated with colonization, we studied a cross-section of a well-described cohort of HIV-seropositive and -seronegative active and former drug users considered at risk for staphylococcal infections. Sixty percent of the 217 subjects were Hispanic, 36% were women, 25% actively used injection drugs, 23% actively used inhalational drugs, 23% received antibiotics, and 35% were HIV-seropositive. Forty-one percent of subjects had positive nasal cultures for S. aureus. The antibiotic susceptibility patterns were similar to the local hospital's outpatient isolates and no dominant strain was identified by arbitrarily primed polymerase chain reaction (AB-PCR). Variables significantly and independently associated with colonization included antibiotic use (odds ratio [OR] = 0.37; confidence interval [CI] = 0.18-0.77), active inhalational drug use within the HIV-seropositive population (OR = 2.36; CI = 1.10-5.10) and female gender (OR = 1.97; CI = 1.09-3.57). Characteristics not independently associated included injection drug use, HIV status, and CD4 count. The association with active inhalational drug use, a novel finding, may reflect alterations in the integrity of the nasal mucosa. The lack of association between HIV infection and S. aureus colonization, which is contrary to most previous studies, could be explained by our rigorous control for confounding variables or by a limited statistical power due to the sample sizes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • AIDS-Related Opportunistic Infections / drug therapy
  • AIDS-Related Opportunistic Infections / epidemiology
  • AIDS-Related Opportunistic Infections / microbiology*
  • Adult
  • Cross-Sectional Studies
  • Female
  • HIV Seronegativity*
  • HIV Seropositivity / epidemiology
  • HIV Seropositivity / microbiology*
  • Humans
  • Longitudinal Studies
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Nasal Mucosa / drug effects
  • Nasal Mucosa / microbiology*
  • Prospective Studies
  • Rhinitis / epidemiology
  • Rhinitis / microbiology
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology
  • Staphylococcal Infections / microbiology*
  • Staphylococcus aureus / drug effects
  • Staphylococcus aureus / growth & development*
  • Staphylococcus aureus / isolation & purification
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / microbiology*
  • Substance-Related Disorders / virology