14th International AIDS Conference


Barcelona, Spain — July 7-12, 2002

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[TITLE:] Increased risk for Staphylococcus aureus colonization linked to CD4 cell count

[AUTHOR(S):] N.J. Moss, F. Perdreau-Remington, D.R. Bangsberg, E.D. Charlebois1

Int Conf AIDS. 2002 Jul 7-12;14:Abstract No. MoOrB1010

BACKGROUND: Staphylococcus aureus is an important cause of bacteremia, pneumonia, and soft tissue infections in HIV(+) individuals. Higher rates of S. aureus colonization have been reported in HIV(+) individuals. We examined the relationship between CD4 cell count and nasal colonization with S. aureus among HIV positives.

METHODS: A representative community-based sample of urban poor in San Francisco consisting of 823 individuals was tested for S. aureus nasal colonization between August 1999 and January 2000. HIV status was investigated as a possible risk factor. All HIV(+) subjects had CD4 counts measured within 30 days of nasal screening. The S. aureus isolates recovered from all HIV(+) and HIV(-) individuals were genotyped by Pulsed Field Gel Electrophoresis and compared to determine clonal relationships.

RESULTS: 140/832 (17.2%) of the study participants were HIV(+). We detected S. aureus colonization in 33.6% of HIV(+) individuals and 20.9% of HIV(-) individuals (p=0.0015). S. aureus colonization rate among HIV(+) individuals increased as CD4 count decreased (see table).

29/98 (29.6%) of individuals with CD4 counts above 200 and 18/42 (42.9%) of individuals with counts below 200 were colonized with S. aureus (p=0.0929). HIV(+) individuals with CD4 counts below 200 had an odds ratio of 1.8 (95%CI=0.84 to 3.8) for colonization. No specific S. aureus clones were associated with HIV(+) status.

CD4 Cell Count 0-50 50-200 200-500 ≥500
Number Colonized/ Total HIV(+) 6/12 12/30 17/52 12/46
Percent Colonized 50% 40% 32.7% 26.1%

CONCLUSIONS: HIV(+) urban outpatients with CD4 counts below 200 have greater rates of S. aureus nasal colonization than those with higher CD4 counts, and likelihood of colonization increases with decreasing CD4 count.

Presenting author: Nicholas Moss

1UCSF School of Medicine, UCSF, Epi-center, Box 1372, 94143-1372, United States.

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MoOrB1010

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