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静脉注射和吸入阿片类药物滥用者中社区获得性耐甲氧西林金黄色葡萄球菌(CA-MRSA)的定植与感染

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) colonization and infection in intravenous and inhalational opiate drug abusers.

作者信息

El-Sharif Amany, Ashour Hossam M

机构信息

Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Kasr El-Aini Street, Cairo, Cairo 11562, Egypt.

出版信息

Exp Biol Med (Maywood). 2008 Jul;233(7):874-80. doi: 10.3181/0711-RM-294. Epub 2008 Apr 29.

DOI:10.3181/0711-RM-294
PMID:18445771
Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in hospital-acquired and community-acquired infections. We hypothesized that drug abuse is a risk factor for community-acquired MRSA (CA-MRSA) infection, and we employed a rapid multiplex PCR technique for MRSA identification. The study was conducted on MRSA isolates from 60 opiate addicts (intravenous and inhalational drug users) to detect the rate and location of MRSA colonization and infection among them in comparison to 60 non-addict patients and 15 healthy volunteer controls. The proportion of addicts with MRSA colonization (and/or infection) was significantly higher than non-addict patients with MRSA colonization. MRSA colonization was associated with infection in 58% of MRSA-colonized addicts. The MRSA nasal carriage in the addicts was significantly higher than MRSA carriage elsewhere, whether in the addicts group or in the non-addict patients group. Moreover, the nasopharyngeal carriage rate of MRSA among addicts was significantly higher than among the non-addict patients. Increasing the duration of addiction resulted in a significant increase in CA-MRSA colonization in opiate addicts. Both inhalational and intravenous drug use led to significant MRSA colonization in the addict population. In conclusion, this study demonstrated how drug abusers, a high-risk group for infections with MRSA, could be a source or a reservoir of CA-MRSA infection in the non-addict population.

摘要

耐甲氧西林金黄色葡萄球菌(MRSA)是医院获得性感染和社区获得性感染中的一种重要病原体。我们假设药物滥用是社区获得性MRSA(CA-MRSA)感染的一个危险因素,并且我们采用了一种快速多重PCR技术来鉴定MRSA。该研究对60名阿片类药物成瘾者(静脉注射和吸入性吸毒者)的MRSA分离株进行,以检测他们中MRSA定植和感染的发生率及部位,并与60名非成瘾患者和15名健康志愿者对照进行比较。有MRSA定植(和/或感染)的成瘾者比例显著高于有MRSA定植的非成瘾患者。在58%的MRSA定植成瘾者中,MRSA定植与感染相关。成瘾者的MRSA鼻腔携带率显著高于其他部位的MRSA携带率,无论是在成瘾者组还是在非成瘾患者组中。此外,成瘾者中MRSA的鼻咽携带率显著高于非成瘾患者。成瘾时间的延长导致阿片类药物成瘾者中CA-MRSA定植显著增加。吸入性和静脉注射吸毒均导致成瘾人群中显著的MRSA定植。总之,本研究证明了药物滥用者作为MRSA感染的高危人群,如何可能成为非成瘾人群中CA-MRSA感染的一个来源或储存库。

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