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Community-associated methicillin-resistant Staphylococcus aureus is prevalent in wounds of community-based injection drug users

  • E. LLOYD-SMITH (a1) (a2), M. W. HULL (a1) (a3), M. W. TYNDALL (a1) (a3), R. ZHANG (a1), E. WOOD (a1) (a3), J. S. G. MONTANER (a1) (a3), T. KERR (a1) (a3) and M. G. ROMNEY (a4) (a5)...

Summary

Injection drug users (IDUs) have an elevated risk for carriage of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). Cutaneous injection-related infections are common in IDUs but detailed studies are few. Based on a subsample of 218 individuals from a community-recruited cohort of IDUs at a supervised injection facility, we investigated the microbiology and related antibiotic susceptibility profiles of isolates from 59 wounds. Twenty-seven percent of subjects had at least one wound and 25 (43%) were culture positive for S. aureus alone [14 MRSA and 11 (19%) methicillin-susceptible (MSSA) isolates]. Sixteen of 18 MRSA isolates were classified as community associated (CA) by the presence of genes encoding for PVL. MRSA and MSSA occurred in mixed infection with other organisms on three and six occasions, respectively. All CA-MRSA isolates were susceptible to tetracycline, vancomycin and linezolid but only 13% were susceptible to clindamycin compared to 63% of MSSA isolates. The frequency of CA-MRSA is a cause for concern in wound infection in the IDU setting.

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Copyright

Corresponding author

*Author for correspondence: M. G. Romney, MD, FRCPC, DTM&H, Medical Microbiologist, Medical Director, Infection Prevention and Control, St Paul's Hospital/Providence Health Care, Vancouver, BC, Canada. (Email: mromney@providencehealth.bc.ca)

References

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1.Ma, XX, et al. Novel type of staphylococcal cassette chromosome mec identified in community-acquired methicillin-resistant Staphylococcus aureus strains. Antimicrobial Agents and Chemotherapy 2002; 46: 11471152.
2.Young, DM, et al. An epidemic of methicillin-resistant Staphylococcus aureus soft tissue infections among medically underserved patients. Archives of Surgery 2004; 139: 947953.
3.Saravolatz, LD, Pohlod, DJ, Arking, LM. Community-acquired methicillin-resistant Staphylococcus aureus infections: a new source for nosocomial outbreaks. Annals of Internal Medicine 1982; 97: 325329.
4.Miller, L, et al. Necrotizing fasciitis caused by community-associated methicillin-resistant Staphylococcus aureus in Los Angeles. New England Journal of Medicine 2005; 352: 14451453.
5.Centres for Disease Control and Prevention. Community-associated MRSA Information for Clinicians (http://www.cdc.gov/ncidod/dhqp/ar_MRSA_ca_clinicians.html). Accessed June 15 2009.
6.Deurenberg, RH, et al. The molecular evolution of methicillin-resistant Staphylococcus aureus. Clinical Microbiology and Infection 2007; 13: 222235.
7.Kowalski, TJ, Berbari, EF, Osmon, DR. Epidemiology, treatment, and prevention of community-acquired methicillin-resistant Staphylococcus aureus infections. Mayo Clinic Proceedings 2005; 80: 12011208.
8.Huang, H, et al. Injecting drug use and community-associated methicillin-resistant Staphylococcus aureus infection. Diagnostic Microbiology and Infectious Diseases 2008; 60: 347350.
9.Saravolatz, LD, et al. Methicillin-resistant Staphylococcus aureus. Epidemiologic observations during a community-acquired outbreak. Annals of Internal Medicine 1982; 1: 1116.
10.King, MD, et al. Emergence of community-acquired methicillin-resistant Staphylococcus aureus USA 300 clone as the predominant cause of skin and soft-tissue infections. Annals of Internal Medicine 2006; 144: 309317.
11.Shannon, K, et al. The impact of unregulated single room occupancy hotels on the health status of illicit drug users in Vancouver. International Journal of Drug Policy 2006; 17: 107114.
12.Nelson, KE, Masters Williams, CF. Infectious Disease Epidemiology: Theory and Practice, 2nd edn. Sudbury, MA: Jones & Bartlett Publishers, 2007.
13.Huang, H, et al. Comparisons of community-associated methicillin-resistant Staphylococcus aureus (MRSA) and hospital-associated MSRA infections in Sacramento, California. Journal of Clinical Microbiology 2006; 44: 24232427.
14.Bradley, J, et al. Anti-infective research and development – problems, challenges, and solutions. Lancet Infectious Diseases 7: 6878.
15.Wood, E, et al. Methodology for evaluating Insite: Canada's first medically supervised safer injection facility for injection drug users. Harm Reduction Journal 2004; 1(1): 9.
16.Costa, A, et al. Rapid detection of mecA and nuc genes in staphylococci by real-time multiplex polymerase chain reaction. Diagnostic Microbiology and Infectious Disease 2005; 51: 1317.
17.Lina, G, et al. Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clinical Infectious Diseases 1999; 29: 11281132.
18.Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Supplement M100-S16. Wayne, PA: Clinical and Laboratory Standards Institute; 2006.
19.Allison, DC, et al. Microbiology of upper extremity soft tissue abscesses in injecting drug abusers. Clinical Orthopaedics and Related Research 2007; 461: 9–13.
20.Brown, PD, Ebright, JR. Skin and soft tissue infections in injection drug users. Current Infectious Disease Reports 2002; 4: 415419.
21.Talan, DA, Summamen, PH, Finegold, SM. Ampicillin/sulbactam and cefoxitin in the treatment of cutaneous and other soft-tissue abscesses in patients with or without histories of injection drug abuse. Clinical Infectious Diseases 2000; 31: 464471.
22.Moran, GJ, et al. Methicillin-resistant S. aureus infections among patients in the emergency department. New England Journal of Medicine 2006; 355: 666674.
23.Ebright, JR, Pieper, B. Skin and soft tissue infections in injection drug users. Infectious Disease Clinics of North America 2002; 16: 697712.
24.Rajendran, PM, et al. Randomized, double-blind, placebo-controlled trial of cephalexin for treatment of uncomplicated skin abscesses in a population at risk for community acquired methicillin-resistant Staphylococcus aureus infection. Antimicrobial Agents and Chemotherapy 2007; 51: 40444048.
25.Lloyd-Smith, E, et al. Prevalence and correlates of abscesses among a cohort of injection drug users. Harm Reduction Journal 2005; 2: 24.
26.Lloyd-Smith, E, et al. Incidence and determinants of initiation into cocaine injection and correlates of frequent cocaine injectors. Drug and Alcohol Dependence 2008; 99: 176182.
27.Topp, L, et al. Prevalence and predictors of injecting-related injury and disease among clients of Australia's needle and syringe programs. Australia and New Zealand Journal of Public Health 2008; 32: 3437.
28.Hope, V, et al. Frequency, factors and costs associated with injection site infections: findings from a national multi-site survey of injecting drug users in England. BMC Infectious Diseases 2008; 8: 120.

Keywords

Community-associated methicillin-resistant Staphylococcus aureus is prevalent in wounds of community-based injection drug users

  • E. LLOYD-SMITH (a1) (a2), M. W. HULL (a1) (a3), M. W. TYNDALL (a1) (a3), R. ZHANG (a1), E. WOOD (a1) (a3), J. S. G. MONTANER (a1) (a3), T. KERR (a1) (a3) and M. G. ROMNEY (a4) (a5)...

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