Increasing of New CA-MRSA Infections Detected in people living with HIV Who Engage in Chemsex in Barcelona: An Ambispective Study.
Chemsex
Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA)
HIV
Men who have sex with men (MSM)
Methamphetamine
Journal
Infectious diseases and therapy
ISSN: 2193-8229
Titre abrégé: Infect Dis Ther
Pays: New Zealand
ID NLM: 101634499
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
05
05
2023
accepted:
03
07
2023
medline:
26
7
2023
pubmed:
26
7
2023
entrez:
26
7
2023
Statut:
ppublish
Résumé
There are no data on community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in the context of the chemsex phenomenon. This study aimed to characterize CA-MRSA-related infections in a cohort of people living with HIV (PLWH) who engage in chemsex. At the Hospital Clinic of Barcelona, from February 2018 to January 2022, we analyzed CA-MRSA infections diagnosed in a cohort of PLWH who engage in chemsex. Epidemiological, behavioral and clinical variables were assessed. Mass spectrometry identification and antimicrobial susceptibility testing were performed on MRSA isolates. Pulse field electrophoresis was used to assess the clonality of the MRSA strains. The presence of Panton-Valentine leukocidin was also investigated. Among the cohort of 299 participants who engage in chemsex, 25 (8%) with CA-MRSA infections were identified, 9 at baseline and 16 with incident cases; the cumulative incidence was 5.5% (95% CI: 3.2%, 8.8%). The most common drugs were methamphetamine (96%) and GHB/GBL (92%). Poly-consumption and slamming were reported by 32% and 46%, respectively. CA-MRSA was isolated from the infection sites of 20 participants, and CA-MRSA colonization was confirmed in the remaining 5 persons. Seventy-one percent had used antibiotics in the previous year. All participants presented with skin and soft tissue infections, 28% required hospitalization, and 48% had recurrence. Of the 23 MRSA isolates further studied, 19 (82,6%) belonged to the same clone. Panton-Valentine leukocidin was detected in all isolates. PLWH who engage in chemsex may present with CA-MRSA infections. Clinical suspicion and microbiological diagnosis are required to provide adequate therapy, and CA-MRSA prevention interventions should be designed.
Identifiants
pubmed: 37491688
doi: 10.1007/s40121-023-00846-6
pii: 10.1007/s40121-023-00846-6
pmc: PMC10505111
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2179-2189Informations de copyright
© 2023. The Author(s).
Références
Bourne A, Reid D, Hickson F, Torres-Rueda S, Weatherburn P. Illicit drug use in sexual settings (‘chemsex’) and HIV/STI transmission risk behaviour among gay men in South London: findings from a qualitative study. Sex Transm Infect. 2015;91(8):564–8.
doi: 10.1136/sextrans-2015-052052
pubmed: 26163510
Lee NE, Taylor MM, Bancroft E, Ruane PJ, Morgan M, McCoy L, et al. Risk factors for community-associated methicillin-resistant staphylococcus aureus skin infections among HIV-positive men who have sex with men. Clin Infect Dis. 2005;40(10):1529–34.
doi: 10.1086/429827
pubmed: 15844078
Nguyen MH. Nasal carriage of and infection with Staphylococcus aureus in HIV-infected patients. Ann Intern Med. 1999;130(3):221.
doi: 10.7326/0003-4819-130-3-199902020-00026
pubmed: 10049200
Parikh MP, Octaria R, Kainer MA. Methicillin-resistant Staphylococcus aureus bloodstream infections and injection drug use, Tennessee, USA, 2015–2017. Emerg Infect Dis. 2020;26(3). Available from: http://wwwnc.cdc.gov/eid/article/26/3/19-1408_article.htm
Cohen AL, Shuler C, McAllister S, Fosheim GE, Brown MG, Abercrombie D, et al. Methamphetamine use and methicillin-resistant staphylococcus aureus skin infections. Emerg Infect Dis. 2007;13(11):1707–13.
doi: 10.3201/eid1311.070148
pubmed: 18217555
pmcid: 3375784
Mihu MR, Roman-Sosa J, Varshney AK, Eugenin EA, Shah BP, Ham Lee H, et al. Methamphetamine alters the antimicrobial efficacy of phagocytic cells during methicillin-resistant Staphylococcus aureus skin infection McDaniel LS, editor. MBio. 2015. https://doi.org/10.1128/mBio.01622-15 .
doi: 10.1128/mBio.01622-15
pubmed: 26507236
pmcid: 4626859
Szumowski JD, Wener KM, Gold HS, Wong M, Venkataraman L, Runde CA, et al. Methicillin-resistant Staphylococcus aureus colonization, behavioral risk factors, and skin and soft-tissue infection at an ambulatory clinic serving a large population of HIV-infected men who have sex with men. Clin Infect Dis. 2009;49(1):118–21.
doi: 10.1086/599608
pubmed: 19480576
De La Mora L, Laguno M, De Lazzari E, Ugarte A, Leal L, Torres B, et al. Vulnerability conditions in a cohort of men who have sex with men who engage in chemsex in Barcelona City: a cross-sectional study. Sex Res Soc Policy. 2022. https://doi.org/10.1007/s13178-022-00702-1 .
doi: 10.1007/s13178-022-00702-1
EUCAST: Expert rules and expected phenotypes. Available from: https://www.eucast.org/expert_rules_and_expected_phenotypes/ .
Lina G, Piemont Y, Godail-Gamot F, Bes M, Peter MO, Gauduchon V, et al. Involvement of panton-valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clin Infect Dis. 1999;29(5):1128–32.
doi: 10.1086/313461
pubmed: 10524952
Skiest D, Brown K, Hester J, Moore T, Crosby C, Mussa H, et al. Community-onset methicillin-resistant Staphylococcus aureus in an urban HIV clinic. HIV Med. 2006;7(6):361–8.
doi: 10.1111/j.1468-1293.2006.00394.x
pubmed: 16903980
Popovich KJ, Weinstein RA, Aroutcheva A, Rice T, Hota B. Community-associated methicillin-resistant Staphylococcus aureus and HIV: intersecting epidemics. Clin Infect Dis. 2010;50(7):979–87.
doi: 10.1086/651076
pubmed: 20192731
Cole J, Popovich K. Impact of community-associated methicillin resistant Staphylococcus aureus on HIV-infected patients. Curr HIV/AIDS Rep. 2013;10(3):244–53.
doi: 10.1007/s11904-013-0161-0
pubmed: 23645115
Crum-Cianflone NF, Burgi AA, Hale BR. Increasing rates of community-acquired methicillin-resistant Staphylococcus aureus infections among HIV-infected persons. Int J STD AIDS. 2007;18(8):521–6.
doi: 10.1258/095646207781439702
pubmed: 17686212
Mathews WC, Caperna JC, Barber RE, Torriani FJ, Miller LG, May S, et al. Incidence of and risk factors for clinically significant methicillin-resistant Staphylococcus aureus infection in a cohort of HIV-infected adults. JAIDS J Acquir Immune Defic Syndr. 2005;40(2):155–60.
doi: 10.1097/01.qai.0000179464.40948.b9
pubmed: 16186732
Imaz A, Cobos-Trigueros N, Falcó V, Dominguez MA, Manzardo C, Pujol M, et al. Community-associated methicillin-resistant Staphylococcus aureus infections in HIV-infected patients in Spain. J Infect. 2013;66(2):199–201.
doi: 10.1016/j.jinf.2012.10.013
pubmed: 23072792
Miller LG, Diep BA. Clinical practice: colonization, fomites, and virulence: rethinking the pathogenesis of community-associated methicillin-resistant Staphylococcus aureus infection. Clin Infect Dis. 2008;46(5):752–60.
doi: 10.1086/526773
pubmed: 18220477
Ikeuchi K, Adachi E, Sasaki T, Suzuki M, Lim LA, Saito M, et al. An outbreak of USA300 methicillin-resistant Staphylococcus aureus among people with HIV in Japan. J Infect Dis. 2021;223(4):610–20.
doi: 10.1093/infdis/jiaa651
pubmed: 33057717
Otto M. Basis of virulence in community-associated methicillin-resistant Staphylococcus aureus. Annu Rev Microbiol. 2010;64(1):143–62.
doi: 10.1146/annurev.micro.112408.134309
pubmed: 20825344
Diep BA, Chambers HF, Graber CJ, Szumowski JD, Miller LG, Han LL, Chen JH, Lin F, Lin J, Phan TH, Carleton HA, McDougal LK, Tenover FC, Cohen DE, Mayer KH, Sensabaugh GF, Perdreau-Remington F. Emergence of multidrug-resistant, community-associated, methicillin-resistant Staphylococcus aureus clone USA300 in men who have sex with men. Ann Intern Med. 2008;148(4):249–57. https://doi.org/10.7326/0003-4819-148-4-200802190-00204 . (Epub 2008 Jan 30).
doi: 10.7326/0003-4819-148-4-200802190-00204
pubmed: 18283202
Kraef C, Alabi AS, Peters G, Becker K, Kremsner PG, Rossatanga EG, Mellmann A, Grobusch MP, Zanger P, Schaumburg F. Co-detection of Panton-Valentine leukocidin encoding genes and cotrimoxazole resistance in Staphylococcus aureus in Gabon: implications for HIV-patients’ care. Front Microbiol. 2015;5(6):60. https://doi.org/10.3389/fmicb.2015.00060 .
doi: 10.3389/fmicb.2015.00060