Monday, May 29, 2023
Isolate and Patient Characteristics for 300 Veterans who had Staphylococcus aureus bacteremia
at 4 Veterans Affairs Medical Centers, USA, 2004–2008*
Infection Characteristics for 300 Veterans who had Staphylococcus aureus Bacteremia
at 4 Veterans Affairs Medical Centers, USA, 2004–2008
Patient and Infection Characteristics for 300 Veterans with Staphylococcus aureus Bacteremia
and Association with Illicit Drug Use at 4 Veterans Affairs Medical Centers, USA, 2004–2008*
Patient and Infection Characteristics for 300 Veterans with Staphylococcus aureus Bacteremia
and Association with USA300 MRSA at 4 Veterans Affairs Medical Centers, USA, 2004–2008*
Independent Risk Factors for USA300 MRSA Bacteremia
Among 300 Veterans at 4 Veterans Affairs Medical Centers, USA, 2004–2008*
This activity is intended for primary care clinicians, infectious disease specialists, and other specialists who care for patients at risk for community-acquired MRSA infection.
The goal of this activity is to review the epidemiology of community-acquired MRSA and its changing pattern of acquisition.
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CME Released: 8/16/2010
Valid for credit through: 8/16/2011
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To assess the association of illicit drug use and USA300 methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, a multicenter study was conducted at 4 Veterans Affairs medical centers during 2004-2008. The study showed that users of illicit drugs were more likely to have USA300 MRSA bacteremia (in contrast to bacteremia caused by other S. aureus strains) than were patients who did not use illicit drugs (adjusted relative risk 3.0; 95% confidence interval 1.9-4.4). The association of illicit drug use with USA300 MRSA bacteremia decreased over time (p = 0.23 for trend). Notably, the proportion of patients with USA300 MRSA bacteremia who did not use illicit drugs increased over time. This finding suggests that this strain has spread from users of illicit drugs to other populations.
Infections caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) are increasing. Outbreaks have been described in a variety of populations, including sports teams, men who have sex with men, prisoners, and children.[1-10] The USA300 MRSA clone has been recognized as the most common strain causing CA-MRSA infections.[11]
CA-MRSA was first reported in illicit drug users in Detroit in 1980.[12] The drug-using population has been identified as a reservoir of CA-MRSA.[13] Because of the repeated injection or inhalation of drugs, the opportunity for a person to cause and spread infection with one's own colonizing strain is multiplied.[13,14] Skin and soft tissue infections are the most common infections in illicit drug users; the USA300 MRSA strain is the cause of up to 75% of these infections.[13-15] Once this strain colonizes or otherwise infects a person, it can then enter the patient's bloodstream and become a potentially life-threatening bloodstream infection.
If admitted to the hospital, illicit drug-using patients with a USA300 MRSA infection complicated by bacteremia serve as a potential reservoir for transmission to other patient populations. This mechanism may be contributing to the replacement of other MRSA strains typically associated with nosocomial infections by USA300 MRSA and may aid this strain in becoming the predominant isolate causing MRSA infections in both healthcare and community settings.[16,17] The objective of this study was to evaluate the association of illicit drug use with USA300 MRSA bacteremia and whether the association is static or has changed over a 5-year period as the USA300 MRSA epidemic has progressed.
