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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

  • Stefano Bassetti (a1), Lea Wolfisberg (a1), Barbara Jaussi (a2), Reno Frei (a3), Marcus F. Kuntze (a4), Manuel Battegay (a1) and Andreas F. Widmer (a2)...
Abstract
AbstractObjectives:

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.

Copyright
Corresponding author
Division of Infections Diseases, University Hospital Basel, CH - 4031 Basel, Switzerland
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1. CE Cherubin , JD Sapira . The medical complications of drug addiction and the medical assessment of intravenous drug users: 25 years later. Ann Intern Med 1993;119:10171028.

3. S Bassetti , M Hoffmann , HC Bucher , U Fluckiger , M Battegay . Infections requiring hospitalization of injection drug users who participated in an injection opiate maintenance program. Clin Infect Dis 2002;34:711713.

4. LD Saravolatz , N Markowitz , L Arking , D Pohlod , E Fisher . Methicillin-resistant Staphylococcus aureus: epidemiologic observations during a community-acquired outbreak. Ann Intern Med 1982;96:1116.

5. F Fleisch , R Zbinden , C Vanoli , C Ruef . Epidemie spread of a single clone of methicillin-resistant Staphylococcus aureus among injection drug users in Zurich, Switzerland. Clin Infect Dis 2001;32:581586.

7. C von Eiff , K Becker , K Machka , H Stammer , G Peters . Nasal carriage as a source of Staphylococcus aureus bacteremia. N Engl J Med 2001;344:1116.

8. S Peacock , I de Silva , FD Lowy . What determines nasal carriage of Staphylococcus aureus? Trends Microbiol 2001;9:605610.

9. CU Tuazon , JN Sheagren . Increased rate of carriage of Staphylococcus aureus among narcotic addicts. J Infect Dis 1974;129:725727.

11. J Rehm , P Gschwend , T Steffen , F Gutzwiller , A Dobler-Mikola , A Uchtenhagen . Feasibility, safety, and efficacy of injectable heroin prescription for refractory opioid addicts: a follow-up study. Lancet 2001;358:14171420.

16. DJ Bibel , R Aly , HR Shinefield , HI Maibach , WG Strauss . Importance of the keratinized epithelial cell in bacterial adherence. J Invest Dermatol 1982;79:250253.

17. FD Lowy , M Miller . New methods to investigate infectious disease transmission and pathogenesis: Staphylococcus aureus disease in drug users. Lancet Infect Dis 2002;2:605612.

18. TV Perneger , F Giner , M del Rio , A Mino . Randomised trial of heroin maintenance programme for addicts who fail in conventional drug treatments. BMJ 1998;317:1318.

19. T Steffen , R Blattler , F Gutzwiller , M Zwahlen . HIV and hepatitis virus infections among injecting drug users in a medically controlled heroin prescription programme. Eur J Public Health 2001;11:425430.

20. MR Naef , HC Bucher , P Erb , N Gyr , S Bassetti , M Battegay . Reduced infections with HIV and hepatitis A during a Swiss intravenous opiate maintenance program. J Acquir Immune Defic Syndr 1999;21:349351.

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Infection Control & Hospital Epidemiology
  • ISSN: 0899-823X
  • EISSN: 1559-6834
  • URL: /core/journals/infection-control-and-hospital-epidemiology
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