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Open Access 26-07-2023 | Human Immunodeficiency Virus | Brief Report

Increasing of New CA-MRSA Infections Detected in people living with HIV Who Engage in Chemsex in Barcelona: An Ambispective Study

Authors: Lorena De La Mora, Cristina Pitart, Laura Morata, Ainoa Ugarte, María Martinez-Rebollar, Elisa De Lazzari, Andrea Vergara, Jordi Bosch, Ignasi Roca, Maria Piquet, Ana Rodriguez, Montserrat Laguno, Juan Ambrosioni, Berta Torres, Ana González-Cordón, Alexy Inciarte, Alberto Foncillas, Josep Riera, Irene Fuertes, Iván Chivite, Esteban Martinez, José L. Blanco, Alex Soriano, Josep Mallolas

Published in: Infectious Diseases and Therapy | Issue 8/2023

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Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusion

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.
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Literature
1.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
2.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
3.
go back to reference Nguyen MH. Nasal carriage of and infection with Staphylococcus aureus in HIV-infected patients. Ann Intern Med. 1999;130(3):221.CrossRefPubMed Nguyen MH. Nasal carriage of and infection with Staphylococcus aureus in HIV-infected patients. Ann Intern Med. 1999;130(3):221.CrossRefPubMed
5.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
7.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
10.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
11.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
12.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
13.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
14.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
15.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
16.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
17.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
18.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
19.
go back to reference Otto M. Basis of virulence in community-associated methicillin-resistant Staphylococcus aureus. Annu Rev Microbiol. 2010;64(1):143–62.CrossRefPubMed Otto M. Basis of virulence in community-associated methicillin-resistant Staphylococcus aureus. Annu Rev Microbiol. 2010;64(1):143–62.CrossRefPubMed
20.
go back to reference 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).CrossRefPubMed 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).CrossRefPubMed
21.
go back to reference 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.CrossRef 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.CrossRef
Metadata
Title
Increasing of New CA-MRSA Infections Detected in people living with HIV Who Engage in Chemsex in Barcelona: An Ambispective Study
Authors
Lorena De La Mora
Cristina Pitart
Laura Morata
Ainoa Ugarte
María Martinez-Rebollar
Elisa De Lazzari
Andrea Vergara
Jordi Bosch
Ignasi Roca
Maria Piquet
Ana Rodriguez
Montserrat Laguno
Juan Ambrosioni
Berta Torres
Ana González-Cordón
Alexy Inciarte
Alberto Foncillas
Josep Riera
Irene Fuertes
Iván Chivite
Esteban Martinez
José L. Blanco
Alex Soriano
Josep Mallolas
Publication date
26-07-2023
Publisher
Springer Healthcare
Published in
Infectious Diseases and Therapy / Issue 8/2023
Print ISSN: 2193-8229
Electronic ISSN: 2193-6382
DOI
https://doi.org/10.1007/s40121-023-00846-6

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