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MRSA colonization: a marker of poor outcome in human immunodeficiency virus infection?
In order to examine the association of MRSA colonization with poor clinical outcome in human immunodeficiency virus (HIV) infection, we retrospectively reviewed the records of 135 HIV-infected patients evaluated and treated for AIDS-defining conditions at a large inner city hospital over a 12-month period. Demographic and outcome data, including MRSA colonization of respiratory sites, were compared between patients who were infected with HIV-1 (HIV group) and patients infected with human immunodeficiency virus type 2 (HIV-2) (HIV-2 group). In addition, we compared the clinical characteristics of patients with and without MRSA colonization. Significantly more of the HIV group (28%) than the HIV-2 group (3%) were colonized with MRSA (p = 0.001). Patients with MRSA colonized were significantly older and more likely to have a history of tuberculosis (TB). Patients with MRSA colonization also had significantly lower hemoglobin levels, higher CD4 cell counts and higher HIV RNA levels. MRSA colonization was not associated with a specific clinical outcome, and there was no significant difference in the mean survival time from the first presentation with clinical AIDS between patients colonized and patients not colonized with MRSA. The presence of MRSA colonization in patients with AIDS appears to be a marker of advanced HIV disease, rather than a marker of poor outcome. This suggests that in the HIV-infected population, the presence of MRSA is a consequence of age and TB disease. The underlying cause of increased risk of MRSA colonization in the HIV-infected population needs further investigation.This invention relates to surgical bone plates and more particularly to a bone plate that is deformed when subjected to a torque applied to the bone and is adapted for attaching to an external fixation apparatus.
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