British Columbia Centre for Excellence in HIV/AIDS, St Paul's Hospital, Vancouver, BC, Canada.
Epidemiol Infect. 2010 May;138(5):713-20. doi: 10.1017/S0950268810000464. Epub 2010 Mar 5.
Injection drug users (IDUs) have an elevated risk for carriage of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). Cutaneous injection-related infections are common in IDUs but detailed studies are few. Based on a subsample of 218 individuals from a community-recruited cohort of IDUs at a supervised injection facility, we investigated the microbiology and related antibiotic susceptibility profiles of isolates from 59 wounds. Twenty-seven percent of subjects had at least one wound and 25 (43%) were culture positive for S. aureus alone [14 MRSA and 11 (19%) methicillin-susceptible (MSSA) isolates]. Sixteen of 18 MRSA isolates were classified as community associated (CA) by the presence of genes encoding for PVL. MRSA and MSSA occurred in mixed infection with other organisms on three and six occasions, respectively. All CA-MRSA isolates were susceptible to tetracycline, vancomycin and linezolid but only 13% were susceptible to clindamycin compared to 63% of MSSA isolates. The frequency of CA-MRSA is a cause for concern in wound infection in the IDU setting.
注射吸毒者（IDU）携带金黄色葡萄球菌的风险增加，包括耐甲氧西林金黄色葡萄球菌（MRSA）。与皮肤注射相关的感染在 IDU 中很常见，但详细的研究很少。基于监督注射设施招募的 IDU 社区队列的 218 名个体的亚样本，我们研究了 59 个伤口分离株的微生物学和相关抗生素敏感性特征。27%的受试者至少有一个伤口，25 名（43%）伤口的金黄色葡萄球菌培养阳性[14 株 MRSA 和 11 株（19%）甲氧西林敏感金黄色葡萄球菌（MSSA）分离株]。18 株 MRSA 分离株中有 16 株通过存在编码 PVL 的基因被归类为社区相关（CA）。MRSA 和 MSSA 分别在三种和六种情况下与其他生物体混合感染。所有 CA-MRSA 分离株对四环素、万古霉素和利奈唑胺敏感，但与 MSSA 分离株的 63%相比，只有 13%对克林霉素敏感。CA-MRSA 的频率是 IDU 环境中伤口感染的一个令人担忧的原因。
