Clostridial myonecrosis cluster among injection drug users: a molecular epidemiology investigation.
A molecular epidemiologic investigation was performed on a cluster of severe necrotizing Clostridium infections in 5 injection drug users admitted to an urban community hospital. Interviews with survivors suggested a point source of infection. Pulsed-field gel electrophoresis of SmaI restriction digests was performed to determine the molecular relatedness of clinically obtained isolates and isolates obtained from heroin samples and the home environment. A common clonal strain was found in Clostridium sordellii isolates from 2 socially unrelated patients and from drug paraphernalia. Clonality of a Clostridium perfringens strain from another patient isolate was identical to an isolate from a syringe found in her home. Other C perfringens isolates from patients, heroin, and the environment were determined to be polyclonal. We postulate that rapid recognition and public health notification led to rapid resolution of the outbreak.
Bangsberg
David R
DR
Epidemiology and Prevention Interventions Center, Box 1372, Room 301, Bldg 100, San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110, USA. db@epi-center.ucsf.edu
Rosen
Judith I
JI
Aragón
Tomás
T
Campbell
Andre
A
Weir
Lucy
L
Perdreau-Remington
Francoise
F
D000328:Adult; D003015:Clostridium Infections / Q000453:epidemiology* / Q000601:surgery; D003016:Clostridium perfringens / Q000235:genetics; D003646:Debridement; D004196:Disease Outbreaks; D005260:Female; D003932:Heroin; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology; D009336:Necrosis; D012495:San Francisco / Q000453:epidemiology; D018461:Soft Tissue Infections / Q000453:epidemiology* / Q000601:surgery; D015819:Substance Abuse, Intravenous
D003932:Heroin