High Perineal and Overall Frequency of Staphylococcus aureus in People Who Inject Drugs, Compared to Non-Injectors

et al. 2019

Preprint

Background: Staphylococcus aureus ( S. aureus ) and methicillin-resistant Staphylococcus aureus (MRSA) remained the predominant cause of infections in drug users. The cross-sectional study aimed to elucidate the prevalence, risk factors, phenotypic and molecular characteristics of S. aureus and MRSA carriage among community-based drug users. Methods: Eligible drug users were asked to complete questionnaires and collect nasal swabs during May and December 2017 in Guangzhou, China. Swabs were processed for identification of S. aureus and MRSA. Antimicrobial susceptibility test and polymerase chain reaction assays were used to detect phenotypic and molecular characteristics for identified isolates. Univariate and multivariate logistic regression analyses were used to assess risk factors for S. aureus and MRSA carriage. Results: Overall, the prevalence of S. aureus and MRSA carriage in 353 drug users were 15.01% and 6.79%, respectively. Cohabitation was a risk factor for S. aureus (adjusted OR=8.80, 95% CI: 1.89-40.99) and MRSA (adjusted OR=14.30, 95% CI: 2.67-76.46) carriage. The proportions of multidrug resistance were respectively 72.41% and 89.47% for S. aureus and MRSA isolates and were simultaneously resistant to penicillin, erythromycin and clindamycin. The results of clonal complexes and sequence types for S. aureus and MRSA isolates were diverse. The proportions of virulence genes were high for MRSA isolates. Conclusion: The prevalence of S. aureus nasal carriage was lower while the prevalence of MRSA nasal carriage was moderate. Phenotypic and molecular characteristics of MRSA isolates revealed serious antibiotic resistance, indicating the cross-circulation of MRSA isolates, and imply high opportunity of virulence-related diseases. Decolonization might be considered for drug users with MRSA carriage, especially for those with risk factors.

Section: Discussionsupporting

confidence: 88%

Prevalence, risk factors, phenotypic and molecular characteristics for methicillin-resistant Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

et al. 2019

Preprint

“…The prevalence of MRSA nasal carriage (6.80%) in the study is similar to the afore mentioned studies in other countries [4,[12][13][14]. Notably, the proportion of MRSA in S. aureus isolates were higher than the observed studies [4,14].…”

Section: Discussionsupporting

confidence: 88%

Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

et al. 2019

Preprint

Background: Staphylococcus aureus (S. aureus), particularly methicillin-resistant Staphylococcus aureus (MRSA), remains the predominant cause of infections in drug users. The cross-sectional study aims to elucidate the prevalence, risk factors, phenotypic and molecular characteristics of S. aureus carriage among community-based drug users.Methods: All eligible drug users, both intravenous and oral drug users, were asked to complete questionnaires and collect nasal swabs during the period between May and December 2017 in Guangzhou, China. Swabs were processed for identification of S. aureus. Antimicrobial susceptibility test and polymerase chain reaction assays were used to detect phenotypic and molecular characteristics for identified isolates. Univariate and multivariate logistic regression analyses were used to assess risk factors for S. aureus carriage.Results: Overall, 353 drug users were included in the study and the prevalence of S. aureus carriage was 15.01% (53/353). The prevalence of MRSA carriage was 6.80% (24/353). Cohabitation was a risk factor for S. aureus (adjusted OR=8.80, 95% CI: 1.89-40.99). The proportion of multidrug resistance was 54.72% for S. aureus isolates and most of these isolates were resistant to penicillin, erythromycin and clindamycin. Seventeen MRSA isolates were multidrug resistant. The results of clonal complexes (CCs) and sequence types (STs) for S. aureus were diverse. The three predominant types for CCs were CC5 (64.15%, 34/53), CC59 (11.32%, 6/53), and CC7 (7.55%, 4/53); and for STs were ST188 (20.75%, 11/53), ST5 (11.32%, 6/53), and ST59 (11.32%, 6/53). Conclusion: The prevalence of S. aureus nasal carriage was lower when the prevalence of MRSA carriage was moderate. Phenotypic and molecular characteristics of S. aureus isolates, particularly MRSA isolates, revealed serious antibiotic resistance, indicating the existence of cross-circulation, and implying high opportunity of virulence-related diseases. Decolonization might be considered for drug users with MRSA carriage.

“…Additionally, we found that a majority of long-term drug users who took drugs by snorting had few vibrissae. This might also be a potential factor leading to a low prevalence of S. aureus carriage, further studies about the impact of snorting drugs on S. aureus carriage need to be conducted in the future The prevalence of MRSA nasal carriage (6.80%) in the study is similar to the previous studies in other countries [4,[12][13][14], but higher than that in the general population in China [15]. Additionally, the proportion of MRSA in S. aureus isolates was higher than the observed studies [4,14].…”

Section: Discussionsupporting

confidence: 82%

Prevalence, risk factors, phenotypic and molecular characteristics for Staphylococcus aureus carriage in community-based drug users in Guangzhou, China

Antimicrob Resist Infect Control

et al. 2020

Background: Staphylococcus aureus (S. aureus), particularly methicillin-resistant Staphylococcus aureus (MRSA), remains the predominant cause of infections in drug users. This cross-sectional study aims to elucidate the prevalence, risk factors, phenotypic and molecular characteristics of S. aureus carriage among community-based drug users. Methods: All eligible drug users, with both injection and non-injection route of drug administration, were asked to complete questionnaires and collect nasal swabs by trained personal during the period between May and December 2017 in Guangzhou, China. Swabs were processed for identification of S. aureus. Antimicrobial susceptibility test and polymerase chain reaction assays were used to detect phenotypic and molecular characteristics for identified isolates. Univariate and multivariate logistic regression analyses were used to assess risk factors for S. aureus carriage. Results: Overall, 353 drug users were included in the study and the prevalence of S. aureus carriage was 15.01% (53/353). The prevalence of MRSA carriage was 6.80% (24/353). Cohabitation was a risk factor for S. aureus (adjusted OR = 8.80, 95% CI: 1.89-40.99). The proportion of multidrug resistance was 54.72% for S. aureus isolates and most of these isolates were resistant to penicillin, erythromycin and clindamycin. Seventeen MRSA isolates were multidrug resistant. The results of clonal complexes (CCs) and sequence types (STs) for S. aureus were diverse. The three predominant types for CCs were CC5 (64.15%, 34/53), CC59 (11.32%, 6/53), and CC7 (7.55%, 4/53); and for STs were ST188 (20.75%, 11/53), ST5 (11.32%, 6/53), and ST59 (11.32%, 6/53). Conclusion: The prevalence of S. aureus nasal carriage was lower while the prevalence of MRSA carriage was moderate compared to previous studies. Phenotypic and molecular characteristics of S. aureus isolates, particularly MRSA isolates, revealed high proportions of antibiotic resistance, indicating the existence of cross-circulation, and implying high opportunity of virulence-related diseases. Decolonization and antibiotic stewardship might be implemented for drug users with MRSA carriage.