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

Bassetti, Stefano; Wolfisberg, Lea; Jaussi, Barbara; Frei, Reno; Kuntze, Marcus F.; Battegay, Manuel; Widmer, Andreas F.

doi:10.1086/502364

Cited by 24 publications

(26 citation statements)

References 17 publications

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“…Similar MRSA screenings of IDUs in other areas of Switzerland and neighboring countries would be interesting and warranted. A study in IDUs in Basel found no MRSA [11].…”

Section: Discussionmentioning

confidence: 96%

Transregional Spread of a Single Clone of Methicillin–Resistant Staphylococcus aureus between Groups of Drug Users in Switzerland

Fleisch

Oechslin

Gujer³

et al. 2005

Infection

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“…Similar MRSA screenings of IDUs in other areas of Switzerland and neighboring countries would be interesting and warranted. A study in IDUs in Basel found no MRSA [11].…”

Section: Discussionmentioning

confidence: 96%

Transregional Spread of a Single Clone of Methicillin–Resistant Staphylococcus aureus between Groups of Drug Users in Switzerland

Fleisch

Oechslin

Gujer³

et al. 2005

Infection

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“…In a multivariate model, being in the oral methadone program was the only significant risk factor for S. aureus carriage (OR 2.27; 95% CI 1.19-4.31; p = 0.012). It is important to note that 66% of the patients in the oral methadone program continued to use iv street drugs [47]. In the second study of 217 active and former drug users, no association between iv drug use and nasal colonization by S. aureus was found, while nasal S. aureus carriage was independently correlated with inhalational drug use in HIV-infected persons [48].These findings suggest that injection of contaminated drugs and inhalational drug use may promote nasal S. aureus colonization, probably by damaging the nasal mucosa, since damaged nasal mucosa is more likely to become colonized by S. aureus [49].…”

Section: Risk Factors For S Aureus Infection In Idus Nasal S Aureusmentioning

confidence: 99%

Staphylococcus aureus Infections in Injection Drug Users: Risk Factors and Prevention Strategies

2004

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Infections, in particular soft tissue infections (cellulitis, skin abscesses), are the leading cause for emergency department visits and hospital admissions of drug injection users (IDUs). Staphylococcus aureus is the most relevant bacterial pathogen in this population. It is the main cause of soft tissue infections and of severe infections such as endocarditis and bacteremia. Moreover, epidemic spread of methicillin-resistant S. aureus (MRSA) among IDUs has occurred in Europe and North America. Nasal carriage of S. aureus is associated with an increased risk of subsequent S. aureus infections, and it has been shown that active IDUs have a higher rate of colonization with S. aureus than the general population. However, it is still unknown why an individual carries S. aureus. In particular, repeated injections do not appear to be the main predisposing factor for S. aureus carriage. Infections associated with injection drug use are frequently the consequence of the illegal status of street drugs. Harm reduction programs, including needle exchange programs, safer injecting facilities and injection opiate substitution programs can reduce the incidence of infections among severely addicted IDUs.

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“…Approximately 30% of the healthy population carries S. aureus in their anterior nares [4,5]. Carriage of S. aureus in the nose appears to play a key role in the epidemiology and pathogenesis of infection and is associated with an increased risk of infectious complications after surgery in patients with end-stage renal failure and in those with intravascular devices [1,6].…”

mentioning

confidence: 99%

Throat Swabs Are Necessary to Reliably Detect Carriers of Staphylococcus aureus

Mertz

Frei

Jaussi

et al. 2007

Clinical Infectious Diseases

211

167

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The anterior nares are the most important screening site of colonization with Staphylococcus aureus. We screened 2966 individuals for S. aureus carriage with swabs of both nares and throat. A total of 37.1% of persons were nasal carriers, and 12.8% were solely throat carriers. Screening of throat swabs significantly increases the sensitivity of detection among carriers by 25.7%.The anterior nares are considered to be the primary colonization site of Staphylococcus aureus [1][2][3]. Approximately 30% of the healthy population carries S. aureus in their anterior nares [4,5]. Carriage of S. aureus in the nose appears to play a key role in the epidemiology and pathogenesis of infection and is associated with an increased risk of infectious complications after surgery in patients with end-stage renal failure and in those with intravascular devices [1,6]. Approximately 80% of invasive nosocomial infections are of endogenous origin in nasal carriers [7,8].The emergence of methicillin-resistant S. aureus (MRSA) in hospitals and in the community has triggered many screening programs to identify carriers of S. aureus-in particular, MRSA. Early identification of carriers is a crucial step in MRSA prevention programs; this is especially true for "search and destroy" strategies, which are recommended in The Netherlands [9]. Screening of all persons who are admitted to the hospital is currently being debated in the United States.Most S. aureus screening programs that include MRSA require obtainment of a swab specimen from the anterior nares

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Carriage ofStaphylococcus aureusAmong Injection Drug Users: Lower Prevalence in an Injection Heroin Maintenance Program Than in an Oral Methadone Program

Cited by 24 publications

References 17 publications

Transregional Spread of a Single Clone of Methicillin–Resistant Staphylococcus aureus between Groups of Drug Users in Switzerland

Transregional Spread of a Single Clone of Methicillin–Resistant Staphylococcus aureus between Groups of Drug Users in Switzerland

Staphylococcus aureus Infections in Injection Drug Users: Risk Factors and Prevention Strategies

Throat Swabs Are Necessary to Reliably Detect Carriers of Staphylococcus aureus

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