Recent sexually transmitted infections (STIs), such as syphilis and nongonococcal urethritis, and public bath use have also been associated with colonization [17]. These data suggest that, in addition to HIV infection or medical factors, lifestyle behaviours may contribute to higher rates of MRSA learn more colonization. Table 1 shows a summary of studies examining MRSA infections among HIV-infected persons [4-6, 9, 10, 16, 20, 22-38]. In the HAART era, the majority (85%) of MRSA infections among HIV-infected out-patients have

been SSTIs [5, 10, 20, 22, 27, 30, 32], similar to the general population [2, 39]. SSTIs also account for a significant proportion of MRSA infections in inpatients and are an increasing cause of hospitalizations [38, 40]. Mathews (2005) [25] 7.1% developed MRSA infection during the study period (6.7% CA-MRSA). The incidence of CA-MRSA infection in 2005 was 40.3/1000 PY. 21% of patients with CA-MRSA developed a recurrent MRSA infection Szumowski* (2007) [27] 179 of 183 cases were MRSA SSTI (abscess, n = 121;

Selisistat mouse cellulitis, n = 17; folliculitis, n = 18; wound infection, n = 15; ulceration, n = 6; impetigo, n = 2). One case of joint infection, one of acute sinusitis, one of BSI and one of pneumonia Today, the majority of SSTIs among HIV-infected persons are caused by CA-MRSA strains [4, 5]. Abscesses are usually the most commonly reported SSTI, followed by cellulitis, furuncles, folliculitis, ulcerations, wound infections and impetigo [5, 24, 27, 30, 32, 34, 37]. SSTIs among HIV-infected patients are usually mild and associated with low rates of complications (e.g. bacteraemia) [5, 32]. Cases of necrotizing fasciitis have emerged, although

there is no indication that HIV-infected persons are at an increased risk for these infections [34, 41-43]. The most common locations of SSTIs have traditionally been Tyrosine-protein kinase BLK the lower and upper extremities, followed by the trunk, axillae, face and neck. Recently, MRSA SSTIs are increasingly reported in the perigenital regions [5, 10, 24, 30, 32, 35, 37, 38, 44]. In the general population, infections with MRSA in these regions have also been documented and associated with high-risk sexual behaviours [45]. MRSA remains an important cause of healthcare-associated bloodstream infections, which increasingly involve community strains (e.g. the USA300 genotype) [16]. Risk factors for bacteraemia include injection drug use (IDU), end-stage renal disease and low CD4 count (<200 cells/μL) [31]. Bloodstream infections may be complicated by the development of endocarditis [38, 46, 47]; however, this complication does not appear to occur at higher rates among HIV-infected persons.