{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T06:37:50Z","timestamp":1791095870582,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,7,24]],"date-time":"2006-07-24T00:00:00Z","timestamp":1153699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2006,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the proportion of skin\/soft tissue infections (SSTIs) and to determine risks for MRSA infection caused by methicillin\u2010resistant Staphylococcus aureus (MRSA) in HIV\u2010infected out\u2010patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective study of SSTIs in HIV\u2010infected out\u2010patients. A questionnaire was used to record MRSA risk factors and treatment. In vitro testing for antibiotic susceptibility, inducible clindamycin resistance, panton\u2010valentine leucocidin (PVL) toxin, and the staphylococcal chromosomal cassette mec (SCCmec) type was performed using standardized methods. Treatment outcomes included resolution of primary site of infection, nonresolution of infection and reinfection and were confirmed at clinic visit and\/or telephone follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010one of 44 patients had an SSTI caused by MRSA. African\u2010Americans comprised 21 of 41 MRSA patients. The median CD4 count of MRSA patients was 411\u2003cells\/\u03bcL. Four patients required hospitalization and three patients had secondary bacteraemia. Twenty\u2010one of 41 MRSA patients had healthcare\u2010associated (HCA) MRSA risk factors including a history of prior MRSA infection (<jats:italic>n<\/jats:italic>=9) and hospitalization within 6 months (<jats:italic>n<\/jats:italic>=11). Other prevalent MRSA risk factors included receipt of systemic antibiotics within 6 months (<jats:italic>n<\/jats:italic>=21) and previous incarceration (<jats:italic>n<\/jats:italic>=19). Twenty\u2010two patients had a significant non\u2010HIV\u2010related comorbid illness. The majority of isolates were susceptible to trimethoprim\u2010sulfamethoxazole, tetracycline, and clindamycin. Inducible clindamycin resistance was detected in 0 of 16 erythromycin\u2010resistant, clindamycin\u2010susceptible MRSA isolates. Twenty\u2010one of 24 isolates tested positive for SCCmec type IV. Twenty\u2010four of 24 isolates tested positive for the PVL gene. Antibiotic treatment was discordant (bacteria nonsusceptible to antibiotic used) in eight MRSA patients. The primary SSTI resolved in 37 of 40 MRSA patients. Recurrence of infection at a site other than the primary site was relatively common (11 patients).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We found a high rate of MRSA causing SSTI in community\u2010dwelling patients. The majority of isolates were positive for PVL and SCCmec IV, which is typical of community\u2010associated MRSA isolates causing SSTIs in the general population. Inducible clindamycin resistance was not detected. Most patients had MRSA risk factors. The initial site of infection resolved in most cases but subsequent MRSA infection was relatively common.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1468-1293.2006.00394.x","type":"journal-article","created":{"date-parts":[[2006,7,24]],"date-time":"2006-07-24T22:17:54Z","timestamp":1153779474000},"page":"361-368","source":"Crossref","is-referenced-by-count":50,"title":["Community\u2010onset methicillin\u2010resistant <i>Staphylococcus aureus<\/i> in an urban HIV clinic"],"prefix":"10.1111","volume":"7","author":[{"given":"D","family":"Skiest","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Hester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Crosby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HR","family":"Mussa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Hoffman\u2010Roberts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,7,24]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/520437"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1086\/323459"},{"key":"e_1_2_5_4_2","first-page":"131","article-title":"Community\u2010acquired methicillin\u2010resistant Staphylococcus aureus","volume":"36","author":"Salgado CD","year":"2003","journal-title":"a meta-analysis of prevalence and risk factors"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/21.5.1308"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.8.593"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1086\/502223"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1086\/502228"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1086\/502227"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1086\/383247"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/322693"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1086\/421090"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-003-0969-4"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-130-3-199902020-00026"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/00042560-199712010-00012"},{"key":"e_1_2_5_16_2","first-page":"51","article-title":"Bacteremia in hospitalized patients infected with the human immunodeficiency virus","volume":"8","author":"Fichtenbaum CJ","year":"1995","journal-title":"a case-control study of risk factors and outcome"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(88)80337-1"},{"key":"e_1_2_5_18_2","first-page":"776","article-title":"Community\u2010acquired bacteremia in patients with acquired immunodeficiency syndrome","volume":"86","author":"Krumholz HM","year":"1989","journal-title":"clinical presentation, bacteriology, and outcome"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-104-4-511"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1086\/322656"},{"key":"e_1_2_5_21_2","first-page":"1253","article-title":"Spectrum of bacterial isolates in HIV\u2010positive patients with skin and soft tissue infections","volume":"17","author":"Bar A","year":"2003","journal-title":"emergence of methicillin-resistant Staphylococci"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1086\/429827"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000179464.40948.b9"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000192004.08153.ea"},{"key":"e_1_2_5_25_2","volume-title":"National Committee for Clinical Laboratory Standards. 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