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Carriage of Staphylococcus aureus Among Injection Drug Users: Lower Prevalence in an Injection Heroin Maintenance Program Than in an Oral Methadone Program

Published online by Cambridge University Press:  02 January 2015

Stefano Bassetti
Affiliation:
Division of Infections Diseases, University Hospital Basel, Basel, Switzerland
Lea Wolfisberg
Affiliation:
Division of Infections Diseases, University Hospital Basel, Basel, Switzerland
Barbara Jaussi
Affiliation:
Division of Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
Reno Frei
Affiliation:
Bacteriology Laboratory, University Hospital Basel, Basel, Switzerland
Marcus F. Kuntze
Affiliation:
Psychiatrie University Clinic Basel, Basel, Switzerland
Manuel Battegay
Affiliation:
Division of Infections Diseases, University Hospital Basel, Basel, Switzerland
Andreas F. Widmer
Affiliation:
Division of Hospital Epidemiology, University Hospital Basel, Basel, Switzerland

Abstract

Objectives:

To compare the prevalence of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) carriage among injection drug users (IDUs) treated in an injection heroin maintenance program with that among IDUs treated in an oral methadone program, and to determine predictors of S. aureus carriage.

Design:

Survey.

Setting:

Two opiate maintenance programs at a psychiatrie university clinic.

Participants:

A volunteer sample consisting of 94 (74%) of 127 IDUs treated in an injection opiate maintenance program with at least twice daily injections of heroin, and 70 (56%) of 125 IDUs treated in an oral methadone program.

Results:

Addicts treated in the intravenous heroin substitution program had a significantly lower overall rate of S. aureus carriage (37 of 94 [39.4%] vs 42 of 70 [60%]; P = .009) and a significantly lower rate of nasal carriage (21 of 94 [22.3%] vs 30 of 70 [42.9%]; P = .005) than did addicts treated in the oral methadone program. Being treated in the oral methadone program was the only independent predictor of S. aureus carriage (odds ratio, 2.27; 95% confidence interval, 1.19-4.31; P=.012). All S. aureus isolates were susceptible to oxacillin.

Conclusions:

The regular use of needles under aseptic conditions did not increase the rate of S. aureus carriage among IDUs. Further studies are necessary to investigate whether the lower rate of S. aureus carriage among IDUs treated with intravenous heroin leads to a lower incidence of S. aureus infections in these patients.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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Carriage of Staphylococcus aureus Among Injection Drug Users: Lower Prevalence in an Injection Heroin Maintenance Program Than in an Oral Methadone Program
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