Table 1.

Recurrent MRSA events in an HIV-infected person

Event no.	MRSA eventsa				Molecular analysisc					Susceptibilityd		HIV-associated factors
	Date (mo/day/yr)	Presentation	Site	Antibiotic treatmentb	USA strain type	SCCmec type	PVL	ACME	msrA	Clindamycin	Tetracyclinee	CD4 count (cells/mm3 [±2 wk])	HIV RNA level (copies/ml [± 2 wk])	Antiretroviral therapyf
1g	7/14/05	SSTI	Lower extremity	Clindamycin, linezolid, mupirocin (2%)							Sensitive			Regimen 1
		SSTI	Head/face	Clindamycin, linezolid, mupirocin (2%)							Sensitive
2	8/16/05	Colonization	Nares									138	1,823	Regimen 1
		Colonization	Groin
3	8/25/05	Colonization	Nares	Mupirocin (2%)										Regimen 1
4	9/13/05	SSTI	Lower extremity	Minocycline → linezolid							Intermediate			Regimen 1
5g	2/14/06	SSTI	Head/face	Daptomycin, minocycline → linezolid							Sensitive
		SSTI	Trunk	Daptomycin, minocycline → linezolid							Intermediate
		SSTI	Buttocks/scrotum	Daptomycin, minocycline → linezolid							Sensitive
6	8/29/06	SSTI	Head/face	Linezolid							Sensitive
		SSTI	Upper extremity	Mupirocin (2%)							Sensitive
		Colonization	Nares	Mupirocin (2%)
7g	1/23/07	SSTI	Upper extremity	Daptomycin → linezolid, rifampin							Resistant	0	>100,000
		SSTI	Buttocks/scrotum	Daptomycin → linezolid, rifampin							Resistant
8	4/10/07	SSTI	Lower extremity	Daptomycin → linezolid							Resistant
		Colonization	Nares	Daptomycin → linezolid
9	6/19/07	SSTI	Upper extremity	Linezolid → daptomycin	USA300	IV	+	+	−	Resistant	Resistant	2	>100,000
		SSTI	Lower extremity	Linezolid → daptomycin	USA300	IV	+	+	−	Resistant	Resistant
		Colonization	Nares	Linezolid → daptomycin	USA300	IV	+	+	−	Resistant	Resistant
10	7/13/07	SSTI	Upper extremity	Linezolid → daptomycin	USA300	IV	+	+	−	Resistant	Resistant	2	>100,000
		SSTI	Upper extremity	Linezolid → daptomycin	USA300	IV	+	+	−	Resistant	Resistant
11	8/1/07	SSTI	Upper extremity	Daptomycin	USA300	IV	+	+	−	Resistant	Resistant
		Colonization	Nares	Daptomycin
12	8/15/07	SSTI	Upper extremity	Linezolid	USA300	IV	+	+	−	Resistant	Resistant			Regimen 2
		Colonization	Nares	Linezolid	USA300	IV	+	+	−	Resistant	Resistant
		Colonization	Axilla	Linezolid	USA300	IV	+	+	−	Resistant	Resistant
		Colonization	Perirectal	Linezolid	USA300	IV	+	+	−	Resistant	Resistant
13	8/17/07	SSTI	Trunk	Daptomycin → linezolid							Resistant			Regimen 2
14	8/27/07	Colonization	Axilla	Mupirocin (2%)	USA300	IV	+	+	−	Resistant	Resistant	28	62,166	Regimen 3
		Colonization	Nares	Mupirocin (2%)	USA300	IV	+	+	−	Resistant	Resistant
15	9/11/07	Colonization	Nares	Mupirocin (2%)	USA300	IV	+	+	−	Resistant	Resistant			Regimen 4
		Colonization	Groin	Mupirocin (2%)	USA300	IV	+	+	−	Resistant	Resistant
		Colonization	Perirectal	Mupirocin (2%)	USA300	IV	+	+	−	Resistant	Resistant
	9/18/07	Colonization	Nares	Mupirocin (2%)	USA300	IV	+	+	−	Resistant	Resistant
16	9/26/07	SSTI	Head/face	Mupirocin (2%; to wound site and nares)	USA300	IV	+	+	−	Resistant	Resistant	20	62,166
		Colonization	Nares	Mupirocin (2%; to wound site and nares)	USA300	IV	+	+	−	Resistant	Resistant
		Colonization	Axilla	Mupirocin (2%; to wound site and nares)	USA300	IV	+	+	−	Resistant	Resistant
		Colonization	Groin	Mupirocin (2%; to wound site and nares)	USA300	IV	+	+	−	Resistant	Resistant
17	10/10/07	Colonization	Nares	Mupirocin (2%)	USA300	IV	+	+	−	Resistant	Resistant	6	34,483
		Colonization	Groin	Mupirocin (2%)	USA300	IV	+	+	−	Resistant	Resistant
18	11/30/07	SSTI	Lower extremity	Linezolid	USA300	IV	+	+	−	Resistant	Resistant	8	>100,000
		Colonization	Nares	Mupirocin (2%)	USA300	IV	+	+	−	Resistant	Resistant
19	1/8/08	Colonization	Nares
20g	3/11/08	SSTI (including necrotizing myositis)	Lower extremity	Clindamycin, daptomycin							Resistant
		Colonization	Nares	Clindamycin, daptomycin
21g	6/19/09	SSTI	Head/face	Linezolid	USA300	IV	+	+	+	Sensitive	Sensitive		214,568	Regimen 5
		SSTI	Lower extremity	Mupirocin (2%)	USA300	IV	+	+	+	Sensitive	Sensitive
		Colonization	Nares	Mupirocin (2%)	USA300	IV	+	+	+	Sensitive	Sensitive
22	11/2/09	SSTI	Lower extremity	Linezolid							Sensitive	14	135,382
23	11/17/09	SSTI	Lower extremity	Daptomycin → minocycline							Sensitive	7	1,328,761
24g	1/7/10	SSTI	Trunk	Daptomycin → minocycline	USA300	IV	+	+	+	Sensitive	Sensitive
		Colonization	Nares	Daptomycin → minocycline	USA300	IV	+	+	+	Sensitive	Sensitive
25	2/10/10	SSTI	Trunk	Minocycline	USA300	IV	+	+	+	Sensitive	Sensitive	7	203,175
26g	3/8/10	SSTI	Lower extremity	Daptomycin → linezolid → minocycline							Sensitive	4	515,260
27	3/16/10	Colonization	Nares
28	3/23/10	SSTI	Trunk	Linezolid → minocycline							Sensitive
		Colonization	Nares	Mupirocin (2%)
29	4/14/10	SSTI	Lower extremity	Linezolid → minocycline	USA300	IV	+	+	+	Sensitive	Sensitive
30	5/4/10	SSTI	Lower extremity	Linezolid → minocycline	USA300	IV	+	+	+	Sensitive	Sensitive	14	798,625
		Colonization	Nares	Mupirocin (2%)	USA300	IV	+	+	+	Sensitive	Sensitive
31	5/18/10	SSTI	Head/face	Daptomycin → minocycline	USA300	IV	+	+	+	Sensitive	Sensitive

^aMRSA events were differentiated based on site and presentation date: SSTI and colonization of the same site occurring within 1 week were grouped as a single event.

^bArrows indicate changes in antibiotic treatment. In some instances, antibiotic courses may have overlapped. All listed antibiotics were systemic, except for mupirocin, which was topical.

^cAll available MRSA isolates were the same with regard to other molecular and susceptibility patterns.

^d“Resistant” was defined as having a clindamycin MIC of ≥2 μg/ml and a tetracycline MIC of ≥8 μg/ml. “Sensitive” was defined as having a MIC of ≤0.5 μg/ml for both antibiotics.

^eFor SSTIs without isolates, tetracycline susceptibility was tested by disk diffusion as part of standard clinical practice.

^fRegimen 1, atazanavir, didanosine, emtricitabine, ritonavir, and tenofovir; regimen 2, atazanavir, didanosine, fosamprenavir, lamivudine, and ritonavir; regimen 3, atazanavir, didanosine, lamivudine, and ritonavir; regimen 4, atazanavir, didanosine, and lamivudine; regimen 5, darunavir, etravirine, lamuvidine, raltegravir, and ritonavir.

^gMRSA event requiring hospital admission.