Staphylococcus aureus carriage and prevalence of skin and soft tissue infections among people who inject drugs: a longitudinal study.
Humans
Soft Tissue Infections
/ epidemiology
Male
Longitudinal Studies
Female
Staphylococcus aureus
/ isolation & purification
Adult
Prevalence
Substance Abuse, Intravenous
/ complications
Carrier State
/ epidemiology
Staphylococcal Skin Infections
/ epidemiology
Middle Aged
Staphylococcal Infections
/ epidemiology
Risk Factors
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
05 06 2024
05 06 2024
Historique:
received:
19
01
2024
accepted:
30
05
2024
medline:
6
6
2024
pubmed:
6
6
2024
entrez:
5
6
2024
Statut:
epublish
Résumé
People who inject drugs are frequently colonized with Staphylococcus aureus and have an increased risk for skin and soft tissue infections. This longitudinal study aims to describe S. aureus carriage in this group and the risk for infections during a 1-year follow-up. We included 61 participants from the Malmö Needle Exchange Program. Mapping of S. aureus carriage was conducted by screening cultures every third month and S. aureus growth was semi-quantified. Data regarding infections and living conditions were collected from structured interviews. Statistics included univariate analysis with the Fischer's exact test, univariate logistic regression and multivariate logistic regression. S. aureus carriage was detected in 46-63% of participants, and 75% reported one or more infections during the study period. Self-reported infections were associated with carriage in perineum (OR 5.08 [95% CI 1.45-17.73]), in skin lesions (OR 1.48 [95% CI 1.21-1.81]), and unstable housing situation (OR 12.83 [95% CI 1.56-105.81]). Thus, people who inject drugs are frequent carriers of S. aureus and report a surprisingly high prevalence of skin and soft tissue infections. Homeless people and those with skin carriage seem to be at highest risk. Effective clinical interventions are needed, aiming at preventing infections in this vulnerable group.
Identifiants
pubmed: 38839902
doi: 10.1038/s41598-024-63574-y
pii: 10.1038/s41598-024-63574-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
12919Subventions
Organisme : Skånes universitetssjukhus
ID : 96112
Organisme : Svenska Läkaresällskapet
ID : SLS589191
Organisme : Scandinavian Society for Antimicrobial Chemotherapy Foundation
ID : SLS785401, SLS685881
Informations de copyright
© 2024. The Author(s).
Références
EMCDDA publishes 2012 report on the state of the drugs problem in Europe. Euro Surveill. 17, 20315 (2012) .
Gordon, R. J. & Lowy, F. D. Bacterial infections in drug users. N. Engl. J. Med. 353, 1945–1954 (2005).
doi: 10.1056/NEJMra042823
pubmed: 16267325
DiNubile, M. J. & Lipsky, B. A. Complicated infections of skin and skin structures: When the infection is more than skin deep. J. Antimicrob. Chemother. 53, ii37-50 (2004).
doi: 10.1093/jac/dkh202
pubmed: 15150182
Summanen, P. H. et al. Bacteriology of skin and soft-tissue infections: Comparison of infections in intravenous drug users and individuals with no history of intravenous drug use. Clin. Infect. Dis. 20, S279-282 (1995).
doi: 10.1093/clinids/20.Supplement_2.S279
pubmed: 7548575
Pollini, R. A. et al. High prevalence of abscesses and self-treatment among injection drug users in Tijuana, Mexico. Int. J. Infect. Dis. 14, e117-122 (2010).
doi: 10.1016/j.ijid.2010.02.2238
pubmed: 20381396
Phillips, K. T. & Stein, M. D. Risk practices associated with bacterial infections among injection drug users in Denver, Colorado. Am. J. Drug Alcohol Abuse. 36, 92–97 (2010).
doi: 10.3109/00952991003592311
pubmed: 20337504
pmcid: 4869685
Binswanger, I. A., Kral, A. H., Bluthenthal, R. N., Rybold, D. J. & Edlin, B. R. High prevalence of abscesses and cellulitis among community-recruited injection drug users in San Francisco. Clin. Infect. Dis. 30, 579–581 (2000).
doi: 10.1086/313703
pubmed: 10722447
Wright, T. et al. Prevalence and severity of abscesses and cellulitis, and their associations with other health outcomes, in a community-based study of people who inject drugs in London, UK. PLoS One. 15, e0235350 (2020).
doi: 10.1371/journal.pone.0235350
pubmed: 32663203
pmcid: 7360031
Doran, J. et al. Factors associated with skin and soft tissue infections among people who inject drugs in the United Kingdom: A comparative examination of data from two surveys. Drug Alcohol Depend. 213, 108080 (2020).
doi: 10.1016/j.drugalcdep.2020.108080
pubmed: 32526658
Dahlman, D., Håkansson, A., Björkman, P., Blomé, M. A. & Kral, A. H. Correlates of skin and soft tissue infections in injection drug users in a syringe-exchange program in Malmo, Sweden. Subst Use Misuse. 50, 1529–1535 (2015).
doi: 10.3109/10826084.2015.1023450
pubmed: 26583450
Kluytmans, J. A. et al. Nasal carriage of Staphylococcus aureus as a major risk factor for wound infections after cardiac surgery. J. Infect. Dis. 171, 216–219 (1995).
doi: 10.1093/infdis/171.1.216
pubmed: 7798667
Bassetti, S. et al. Carriage of Staphylococcus aureus among injection drug users: Lower prevalence in an injection heroin maintenance program than in an oral methadone program. Infect. Control Hosp. Epidemiol. 25, 133–137 (2004).
doi: 10.1086/502364
pubmed: 14994939
Dahlman, D. et al. High perineal and overall frequency of staphylococcus aureus in people who inject drugs, compared to non-injectors. Curr. Microbiol. 74, 159–167 (2017).
doi: 10.1007/s00284-016-1165-y
pubmed: 27896481
Kluytmans, J., van Belkum, A. & Verbrugh, H. Nasal carriage of Staphylococcus aureus: Epidemiology, underlying mechanisms, and associated risks. Clin. Microbiol. Rev. 10, 505–520 (1997).
doi: 10.1128/CMR.10.3.505
pubmed: 9227864
pmcid: 172932
von Eiff, C., Becker, K., Machka, K., Stammer, H. & Peters, G. Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N. Engl. J. Med. 344, 11–16 (2001).
doi: 10.1056/NEJM200101043440102
Dwyer, R. et al. Prevalences and correlates of non-viral injecting-related injuries and diseases in a convenience sample of Australian injecting drug users. Drug Alcohol Depend. 100, 9–16 (2009).
doi: 10.1016/j.drugalcdep.2008.08.016
pubmed: 19013725
Socialstyrelsen. En uppskattning av omfattningen av injektionsmissbruket i Sverige. Stockholm. Available from: https://www.socialstyrelsen.se/publikationer/ (2013).
IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp
Wertheim, H. F. et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect. Dis. 5, 751–762 (2005).
doi: 10.1016/S1473-3099(05)70295-4
pubmed: 16310147
Williams, R. E. Healthy carriage of Staphylococcus aureus: Its prevalence and importance. Bacteriol. Rev. 27, 56–71 (1963).
doi: 10.1128/br.27.1.56-71.1963
pubmed: 14000926
pmcid: 441169
Hope, V., Kimber, J., Vickerman, P., Hickman, M. & Ncube, F. Frequency, factors and costs associated with injection site infections: Findings from a national multi-site survey of injecting drug users in England. BMC Infect. Dis. 8, 120 (2008).
doi: 10.1186/1471-2334-8-120
pubmed: 18801177
pmcid: 2600824
Lloyd-Smith, E. et al. Risk factors for developing a cutaneous injection-related infection among injection drug users: A cohort study. BMC Public Health. 8, 405 (2008).
doi: 10.1186/1471-2458-8-405
pubmed: 19068133
pmcid: 2621202
Kasper, K. J. et al. A controlled-release oral opioid supports S. aureus survival in injection drug preparation equipment and may increase bacteremia and endocarditis risk. PLoS One. 14, e0219777 (2019).
doi: 10.1371/journal.pone.0219777
pubmed: 31398210
pmcid: 6688832
Lloyd-Smith, E. et al. Prevalence and correlates of abscesses among a cohort of injection drug users. Harm. Reduct. J. 2, 24 (2005).
doi: 10.1186/1477-7517-2-24
pubmed: 16281979
pmcid: 1308840
Morrison, A., Elliott, L. & Gruer, L. Injecting-related harm and treatment-seeking behaviour among injecting drug users. Addiction. 92, 1349–1352 (1997).
pubmed: 9489051
Jenkins, T. C. et al. Microbiology and initial antibiotic therapy for injection drug users and non-injection drug users with cutaneous abscesses in the era of community-associated methicillin-resistant Staphylococcus aureus. Acad. Emerg. Med. 22, 993–997 (2015).
doi: 10.1111/acem.12727
pubmed: 26202847
pmcid: 4843999
MacLeod, C. S. et al. The needle and the damage done: A retrospective review of the health impact of recreational intravenous drug use and the collateral consequences for vascular surgery. Ann. Vasc. Surg. 78, 103–111 (2022).
doi: 10.1016/j.avsg.2021.06.018
pubmed: 34474130
Swedres-Svarm 2022. Sales of antibiotics and occurrence of resistance in Sweden. Solna/Uppsala. ISSN 2001–7901. https://www.sva.se/media/ticcp2zu/swedres-svarm-2022-edit-230808.pdf (2023).