Prevalence of methicillin-resistant Staphylococcus aureus colonization in HIV-infected patients in Barcelona, Spain: a cross-sectional study.

BACKGROUND: Colonization by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has been found to be markedly more common in HIV-infected individuals in the USA. Studies evaluating the prevalence MRSA colonization in HIV-infected populations in Europe are scarce. The aim of this study was to investigate the prevalence of MRSA colonization in a cohort of HIV-infected patients in Barcelona, Spain. METHODS: Nasal and pharyngeal S. aureus carriage was assessed in a random sample of 190 patients from an outpatient HIV clinic. Nasal and pharyngeal swab specimens were obtained for staphylococcal culture from 190 and 110 patients respectively. All MRSA isolates were screened for Panton-Valentine leukocidin (PVL) genes by PCR. Molecular characterization of MRSA isolates was performed by multilocus sequence typing. Data related to HIV infection, healthcare exposure, and previously described risk factors for MRSA were collected from medical records and a questionnaire administered to each patient. RESULTS: The patients' characteristics were as follows: male, 83 %; median (IQR) age, 45 (39-49) years; intravenous drug users, 39 %; men who have sex with men, 32 %; heterosexual, 26 %; CD4 count, 528/µL (IQR 351-740); on antiretroviral therapy, 96 %; and undetectable plasma viral load, 80 %. Sixty-five patients (34 %) were colonized by S. aureus. MRSA colonization was found in 1 % and 2 % of nasal and pharyngeal samples respectively. No PVL positive MRSA strains were detected and all the MRSA isolates belonged to typical hospital-acquired clones. CONCLUSIONS: Our data suggest that CA-MRSA colonization is not currently a problem in HIV-infected individuals in our area.

Procedimiento de cuidados en cirugía craneal sin rasurado en el Hospitla Universitaio de Bellvitge / Procedure of taken care of in shaved surgery craneal withour in HUB

El procedimiento de higiene pre y post quirúrgica del paciente de neurocirugía en el Hospital Universitario de Bellvitge, iniciado en el año 1995, garantiza la correcta preparación de la zona quirúrgica. La frecuencia y realización del lavado terapéutico reduce el riesgo de infección de la herida y mantiene la integridad del cuero cabelludo. Minimiza la angustia prequirúrgica del paciente y mejora la adaptación a los cambios corporales por cirugía(AU)

The procedure of hygiene pre and post surgical of the patient of neurosurgery in the University Hospital of Bellvitge, initiated in 1995, guarantees the correct preparation of the surgical zone, the frequency and accomplishment of the therapeutic washing reduces the risk of infection of the wound and maintains the integrity of the hairy leather. It diminishes the presurgical anguish of the patient and improves the adaptation to the corporal changes by surgery(AU)