Recent literature has described the emergence of a multidrug-resistant USA-300 strain
that has accumulated genes conferring resistance not only to beta-lactams, but also to fluoroquinolones, tetracyclines, macrolides, clindamycin and mupirocin . These strains appear to be common among MSM, with an overall prevalence of 26 cases per 100 000 persons in MSM in one study where MSM status was identified as a risk factor for multidrug-resistant USA-300 strain, independent of HIV status . UK-371804 in vivo Of all MRSA infections among our MSM population, only one (5.3%) was a multidrug-resistant isolate, and it was not a USA-300. According to our definition of multidrug resistance (resistance Selleckchem MAPK inhibitor to more than two classes of antimicrobials other than beta-lactams) we had a total of eight multidrug-resistant isolates,
five of which were USA-300. Our study had several limitations. Not all patients seen in our ID clinic undergo MRSA surveillance cultures, not all isolates were available for PFGE, and complete antibiotic susceptibilities were not reported for each isolate. Additionally, although ART use within the previous year was documented, patient compliance was not assessed in our study. Unlike previous findings, our multivariate analysis did not show an increased risk of MRSA colonization or infection among injecting drug users, MSM or patients with prior incarceration. This may be explained
by our patient population, our sample size, or underreporting of homosexual activity and IDU. In summary, MRSA infection, and specifically USA-300 CA-MRSA infection, occurs in HIV-infected patients. As previously demonstrated, prior antibiotic exposure and a CD4 count <200 cells/μL proved to be independent risks for colonization or infection with MRSA in our study population. Most interesting was our novel finding that HIV-infected patients who received ART in the past year had a significantly decreased risk of MRSA colonization or infection. Further studies are warranted to determine whether HIV-infected patients with recurrent MRSA infections should be considered for earlier Histamine H2 receptor initiation of ART or offered decolonization. “
“The aim of the study was to determine the prevalence and risk factors for HIV-associated fatigue in the era of highly active antiretroviral therapy (HAART). A cross-sectional survey of 100 stable HIV-infected out-patients was carried out. Severity of fatigue was measured using the Fatigue Impact Scale (FIS). Symptoms of orthostatic intolerance (dysautonomia) were evaluated using the Orthostatic Grading Scale (OGS). Data for HIV-infected patients were compared with those for 166 uninfected controls and 74 patients with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (encephalopathy) (ME).