Carriage of Staphylococcus aureus among injection drug users: lower prevalence in an injection heroin maintenance program than in an oral methadone program.
OBJECTIVE
To compare the prevalence of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) carriage among injection drug users (IDUs) treated in an injection heroin maintenance program with that among IDUs treated in an oral methadone program, and to determine predictors of S. aureus carriage.


METHODS
Survey.


METHODS
Two opiate maintenance programs at a psychiatric university clinic.


METHODS
A volunteer sample consisting of 94 (74%) of 127 IDUs treated in an injection opiate maintenance program with at least twice daily injections of heroin, and 70 (56%) of 125 IDUs treated in an oral methadone program.


RESULTS
Addicts treated in the intravenous heroin substitution program had a significantly lower overall rate of S. aureus carriage (37 of 94 [39.4%] vs 42 of 70 [60%]; P = .009) and a significantly lower rate of nasal carriage (21 of 94 [22.3%] vs 30 of 70 [42.9%]; P = .005) than did addicts treated in the oral methadone program. Being treated in the oral methadone program was the only independent predictor of S. aureus carriage (odds ratio, 2.27; 95% confidence interval, 1.19-4.31; P = .012). All S. aureus isolates were susceptible to oxacillin.


CONCLUSIONS
The regular use of needles under aseptic conditions did not increase the rate of S. aureus carriage among IDUs. Further studies are necessary to investigate whether the lower rate of S. aureus carriage among IDUs treated with intravenous heroin leads to a lower incidence of S. aureus infections in these patients.
Division of Infectious Diseases, University Hospital Basel, Basel, Switzerland.
Stefano
S
Bassetti
Lea
L
Wolfisberg
Barbara
B
Jaussi
Reno
R
Frei
Marcus F
MF
Kuntze
Manuel
M
Battegay
Andreas F
AF
Widmer
D000284:Administration, Oral; D000328:Adult; D002353:Carrier State; D005260:Female; D003932:Heroin / Q000008:administration & dosage*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000382:microbiology*; D015995:Prevalence; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D015819:Substance Abuse, Intravenous / Q000188:drug therapy / Q000382:microbiology*; D013557:Switzerland
D003932:Heroin; D008691:Methadone