Link: Journal of the Plague Years: 1981—2008 | The New York Observer.
In another, much smaller study, presented in 2004, researchers interviewed 12 gay men in New York with MRSA. Eleven of them had used crystal meth in the previous three months. Do 11 out of 12 gay men use crystal? Of course not. Eleven out of 12 gay men with MRSA did! Also, 11 of them shaved their body hair. No anal sex needed for transmission!
Link: Higher Rates Of MRSA Among Drug Users Than Six Years Ago.
In a study conducted in 2000, researchers found that among 229 injection drug users, 27% had S. aureus nasal colonization and an overall MRSA colonization rate of 7.4%. In the current study researchers collected 301 samples from injection drug users and found an S. aureus colonization rate of 39.5%. Further testing of the S. aureus isolates showed an overall MRSA rate of 18.6% indicating a significant increase over the last six years. "MRSA nasal colonization in this population has increased significantly within the last six years," say the researchers. "This study highlights the need for interventional measures in high-risk groups, not only to minimize further acquisition in these populations but also to prevent the spread of community strains within health care facilities and the general population."
Link: HighWire Press -- Medline Abstract.
Cases were CA-MRSA-infected patients at University of California, Davis, Medical Center, Sacramento, CA, from December 1, 2003, to May 31, 2004. Two control groups were community-associated methicillin-susceptible S. aureus (CA-MSSA)-infected patients and a randomly selected uninfected patient group in the same hospital. Controls were matched to cases by age and isolate culture date. One hundred twenty-seven CA-MSSA patients and 381 randomly selected uninfected controls were selected to match the 127 CA-MRSA cases. The adjusted odds ratio of injecting drug use compared with the CA-MSSA group was 2.11 (95% confidence interval [CI], 1.1-4.3) and 4.09 (95% CI, 2.2-7.5) compared with the uninfected group. We suggest that injecting drug use is a significant risk factor for CA-MRSA infection, which could contribute to the increasing prevalence of CA-MRSA in an urban community.
Link: BCNG Portals Page.
The News received an advance release of the study in which microbiologist Dr. Nevio Cimolai describes hospitals as “hotbeds of infection” and “reservoirs for community – acquired infections.” Fifteen Fraser Valley patients in the study suffered infections on their arms, hands, buttocks, breasts, legs and nasal passages. Of interest, two got the infection after exposure to a family or a friend in a health care facility, two children had no apparent risk factors, while seven were drug users who shared dirty needles. The mortality rate associated with MRSA is “considerable,” yet it is unknown at this time, wrote Cimolai. Arsenault said this is troublesome. “One of the reasons we want it to be reportable to the B.C. Centre for Disease Control is so that we can document the number of cases in the community,” she said. Antibiotic-resistant bacteria are typically carried by about 30 per cent of the population with no noticeable health impacts, however, it may suddenly cause serious medical problems in otherwise healthy people when it invades the body.
Link: ajc.com.
Lab analysis showed two-thirds of the patients with skin problems were infected with CA-MRSA. Ten percent of them admitted to being regular users of meth — but only 2 percent of those who had no skin infections said they used the drug. The finding came as a surprise, Cohen said, because the skin lesions in the patients who had used meth were not limited to parts of the body where they might have injected the drug. But most of the meth users did not inject the drug, according to what they told investigators; they smoked or inhaled it. Instead, Cohen said, the bug was probably spread by skin-to-skin contact during sex while the users were high, and also by intense scratching — meth users' response to a side effect of the drug, called formication, that makes them feel as though ants are crawling over their skin. Scratching breaks the skin surface and can introduce infection. With the spread of MRSA among meth users, investigators said they are concerned that it is likely to move quickly into the community at large. "Part of the reason we feel this is important is it can impact other family members and the larger community, and will spread to community members who don't use meth," Cohen said.
Link: Journal of Medical Microbiology.
Pyomyositis is a disease of abscess formation deep within large striated muscles. Outside of the tropics it is a rare disease which occurs mainly in certain patient populations such as the immunosuppressed or intravenous drug users (IDUs). A case of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) pyomyositis in an IDU is described. The incidence of both CA-MRSA and pyomyositis is currently increasing. To the authors' knowledge this is the first reported case of CA-MRSA pyomyositis in the UK. Cases of CA-MRSA pyomyositis are likely to increase and it may be necessary to empirically treat certain patients with glycopeptides.
Link: HighWire Press -- Medline Abstract.
An epidemic spread of methicillin-resistant Staphylococcus aureus (MRSA) among intravenous drug users (IDUs) has been observed in Zurich. In the present study we investigated the situation in the Grisons, Switzerland. A total of 191 nose swabs from 111 IDUs and 80 caregivers was analyzed. None of the caregivers was MRSA positive. Six IDUs were asymptomatic MRSA carriers (5.4%). They participated in the official heroin program (MRSA prevalence in this group 16%). The MRSA genotype was identical with the single clone found in IDUs in Zurich, strongly suggesting an epidemic spread. Decolonization was successful in two persons only. Persistence of MRSA in IDUs must therefore be assumed.
Link: Health Protection Agency
There has been recent media interest in community acquired MRSA (C-MRSA) but the Health Protection Agency are unaware of any link to gyms or healthclubs. Over the past three years, the Agency has identified approximately 100 cases of C-MRSA in the UK, and one patient has unfortunately died. These cases have been acquired within the community. So far, most of the UK cases identified have been seen in injecting drug users. Several other countries have encountered more serious problems with C-MRSA. Risk factors in these countries have included gay massage parlours and close-contact sports such as rugby or wrestling. In these situations, skin abrasions are common, so leaving the person more prone to contracting C-MRSA. Other risk groups in the US have included individuals who have stayed in jails and there have been infections described in children. In some countries these strains have also been seen in hospitals.
Link: Telegraph
Worldwide, infections with MRSA are increasingly community-acquired and increasingly prevalent among young, otherwise healthy, adults. Initially MRSA – Methicillin-resistant Staphylococcus aureus – was a problem affecting hospitals and nursing homes, due primarily to lack of hygiene. It was concentrated among the elderly who have weaker immune systems. Last week, it emerged that deaths caused by MRSA in British hospitals have doubled in four years to almost 1,000 a year. But beginning in the early 1980s, cases of community-acquired MRSA were reported in the United States, primarily in people with a history of injecting drugs. Then, between December 2002 and June 2003, four cases of MRSA skin infections without previous hospitalisation were recorded in different areas of Germany. One was a child in an Arab family living in Germany, another was a child in a Greek family living in Germany. The third sufferer, a woman, had acquired her infection in Russia. The fourth, also a woman, divided her time between Egypt and Germany and had multiple skin abscesses.
BBC NEWS
Two in five injecting drug users are infected with hepatitis C - double the number three years ago, a study says. The Health Protection Agency figures for 2003 showed 18% of those who had first injected in the past three years were infected with the disease. The report also revealed evidence of MRSA infections - the superbug traditionally associated with hospitals - as well as rises in other infections. More needed to be done to prevent drug misusers getting infections, it added.
A short introduction from Dave Roberts
This 12 minute introduction will help you grasp the key facts and the key issues surrounding drug resistant staph aureus (mersa, mursa)
