Nasopharyngeal carriage ofStaphylococcus aureus and carriage of tetracycline-resistant strains associated with HIV-seropositivity

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The aim of this prospective study was to investigate the relationship between carriage of antibiotic-resistantStaphylococcus aureus and infection with the human immunodeficiency virus (HIV). A total of 554 pernasal swabs was taken during a six-month period from 554 adult patients attending three outpatient clinics and from inpatients from a hospital in Nairobi, Kenya. Overall, 121 swabs (22 %) yieldedStaphylococcus aureus, there being significantly higher carriage in HIV-positive patients (71/264, 27 %) than in HIV-negative patients (50/290, 17 %); p=0.008. Antimicrobial resistance rates were determined for 110 isolates and were high for penicillin (91 %) and tetracycline (72 %) and low for erythromycin (8 %), methicillin (3 %), gentamicin (5 %) and chloramphenicol (0 %). Genetic analysis showed plasmids in the range of 24–42 MDa to be associated with β-lactamase production and plasmids in the range of 3–5 MDa to be associated with resistance to tetracycline, erythromycin and trimethoprim. All nine erythromycin-resistant strains were from HIV-positive patients (p=0.02). There was a significant association of tetracycline resistance with HIV seropositivity (p=0.002). The association of HIV seropositivity withStaphylococcus aureus carriage and carriage of antibiotic-resistant strains against the background of the HIV epidemic are of relevance in individual patient care and raise concern for public health.