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

  • M. Amir
  • J. Paul
  • B. Batchelor
  • S. Kariuki
  • J. Ojoo
  • P. Waiyaki
  • C. Gilks


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.


  1. 1.
    Godfrey ME, Smith IM: Hospital hazards of staphylococcal sepsis. Journal of the American Medical Association 1958, 166: 1197–1201.PubMedGoogle Scholar
  2. 2.
    Tuazon CU, Perez A, Kishaba T, Sheagren SN:Staphylococcus aureus among insulin-injecting diabetic patients. Journal of the American Medical Association 1975, 231: 1272.CrossRefPubMedGoogle Scholar
  3. 3.
    Tuazon CU, Murray HW, Parrish AE, Sheagren SN:Staphylococcus aureus carriage rate of patients receiving long-term hemodialysis. Archives of Internal Medicine 1978, 138: 1657–1659.CrossRefPubMedGoogle Scholar
  4. 4.
    Tuazon CU, Sheagren SN: Increased rate of carriage ofStaphylococcus aureus among narcotic addicts. Journal of Infectious Diseases 1974, 129: 725–727.PubMedGoogle Scholar
  5. 5.
    Ganesh R, Castle D, McGibbon D, Phillips I, Bradbeer C: Staphylococcal carriage and HIV infection. Lancet 1989, ii: 558.CrossRefGoogle Scholar
  6. 6.
    Battan R, Raviglione MC, Wallace J, Cort S, Boyle JF, Taranta A:S. aureus carriage among homosexual men with and without HIV infection. American Journal of Infection Control 1991, 19: 98–100.CrossRefPubMedGoogle Scholar
  7. 7.
    Weinke T, Schiller R, Fehrenbach FJ, Pohle HD: Association betweenStaphylococcus aureus nasopharyngeal colonization and septicemia in patients infected with the human immunodeficiency virus. European Journal of Clinical Microbiology & Infectious Diseases 1992, 11: 985–989.Google Scholar
  8. 8.
    Jacobson MA, Gellerman H, Chambers H:Staphylococcus aureus bacteremia and recurrent staphylococcal infection in patients with acquired immunodeficiency syndrome and AIDS-related complex. American Journal of Medicine 1988, 85: 172–176.PubMedGoogle Scholar
  9. 9.
    Gabriel Botella F, Labios Gómez M, Balaguer Martínez JV, Vera Sempere G, Tormo Díaz M, Roda Ribera J: Endocarditis en adictos a drogas por vía parenteral: estudio de 57 casos. Annales de Medicina Interna 1992, 9: 473–477.Google Scholar
  10. 10.
    Widrow CA, Kellie SM, Saltzman BR, Mathur-Wagh U: Pyomyositis in patients with the human immunodeficiency virus: an unusual form of disseminated bacterial infection. American Journal of Medicine 1991, 91: 129–136.CrossRefPubMedGoogle Scholar
  11. 11.
    Schwartzman WA, Lambertus MW, Kennedy CA, Goetz MB: Staphylococcal pyomyositis in patients infected by the human immunodeficiency virus. American Journal of Medicine 1991, 90: 595–600.PubMedGoogle Scholar
  12. 12.
    Christin L, Sarosi GA: Pyomyositis in North America: case reports and reviews. Clinical Infectious Diseases 1992, 15: 668–677.PubMedGoogle Scholar
  13. 13.
    Muñoz Fernández S, Quiralte J, del Arco A, Balsa A, Cardenal A, Peña JM, Vázquez JJ, Gijón Baños J: Osteoarticular infection associated with the human immunodeficiency virus. Clinical and Experimental Rheumatology 1991, 9: 489–493.PubMedGoogle Scholar
  14. 14.
    Hughes RA, Rowe IF, Shanson D, Keat AC: Septic bone, joint and muscle lesions associated with human immunodeficiency virus infection. British Journal of Rheumatology 1992, 31: 381–388.PubMedGoogle Scholar
  15. 15.
    Dreyfuss D, Djedaini K, Bidault-Lapomme C, Coste F: Nontraumatic acute anterior mediastinitis in two HIV-positive heroin addicts. Chest 1992, 101: 583–585.PubMedGoogle Scholar
  16. 16.
    Aristimuno B, Nirankari VS, Hemady RK, Rodrigues MM: Spontaneous ulcerative keratitis in immunocompromised patients. American Journal of Ophthalmology 1993, 115: 202–208.PubMedGoogle Scholar
  17. 17.
    Berger TG, Obuch ML, Goldschmidt RH: Dermatologic manifestations of HIV infection. American Family Physician 1990, 41: 1729–1742.PubMedGoogle Scholar
  18. 18.
    Jaffe D, May LP, Sanchez M, Moy J: Staphylococcal sepsis in HIV antibody seropositive psoriasis patients. Journal of the American Academy of Dermatology 1991, 24: 970–972.PubMedGoogle Scholar
  19. 19.
    Pos O, Stevenhagen A, Meenhorst PL, Kroon FP, Van Furth R: Impaired phagocytosis ofStaphylococcus aureus by granulocytes and monocytes of AIDS patients. Clinical and Experimental Immunology 1992, 88: 23–28.PubMedGoogle Scholar
  20. 20.
    Gilks CF, Brindle RJ, Otieno LS, Simani PM, Newnham RS, Bhatt SM, Lule GN, Okelo GBA, Watkins WM, Waiyaki PG, Were JBO, Warrell DA: Life threatening bacteraemia in HIV-1 seropositive adults admitted to hospital in Nairobi, Kenya. Lancet 1990, 336: 545–549.CrossRefPubMedGoogle Scholar
  21. 21.
    Milne LM, Curtis GDW, Crow M, Kraak WAG, Selkon JB: Comparison of culture media for detecting methicillin resistance inStaphylococcus aureus and coagulase negative staphylococci. Journal of Clinical Pathology 1987, 40: 1178–1181.PubMedGoogle Scholar
  22. 22.
    Birnboim HC, Doly J: A rapid alkaline extraction procedure for screening recombinant plasmid DNA. Nucleic Acids Research 1979, 7: 1513–1523.PubMedGoogle Scholar
  23. 23.
    Chuard C, Vaudaux P, Waldvogal FA, Lew DP: Susceptibility ofStaphylococcus aureus on fibronectincoated surfaces to bactericidal antibiotics. Antimicrobial Agents and Chemotherapy 1993, 37: 625–632.PubMedGoogle Scholar
  24. 24.
    Barry AL, Thornsberry C: Susceptibility tests: diffusion test procedures. In: Lennette EH, Balows A, Hausler WJ, Shadomy HG (ed): Manual of clinical microbiology. American Society for Microbiology, Washington, 1985, p. 978–987.Google Scholar

Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1995

Authors and Affiliations

  • M. Amir
    • 1
  • J. Paul
    • 2
  • B. Batchelor
    • 2
  • S. Kariuki
    • 3
  • J. Ojoo
    • 3
  • P. Waiyaki
    • 3
  • C. Gilks
    • 4
  1. 1.Wellcome Trust Research LaboratoriesKilifiKenya
  2. 2.Public Health Laboratory, Level 7John Radcliffe HospitalOxfordUK
  3. 3.Kenya Medical Research Institute, c/o Wellcome Trust Research LaboratoriesNairobiKenya
  4. 4.Liverpool School of Tropical MedicineLiverpoolUK

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