title: Injecting drug use and community-associated methicillin-resistant Staphylococcus aureus infection.
abstract: To demonstrate that injecting drug use is a major risk factor of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection and injecting drug users may be a reservoir of CA-MRSA infection in our community, we conducted a matched case-control study. Cases were CA-MRSA-infected patients at University of California, Davis, Medical Center, Sacramento, CA, from December 1, 2003, to May 31, 2004. Two control groups were community-associated methicillin-susceptible S. aureus (CA-MSSA)-infected patients and a randomly selected uninfected patient group in the same hospital. Controls were matched to cases by age and isolate culture date. One hundred twenty-seven CA-MSSA patients and 381 randomly selected uninfected controls were selected to match the 127 CA-MRSA cases. The adjusted odds ratio of injecting drug use compared with the CA-MSSA group was 2.11 (95% confidence interval [CI], 1.1-4.3) and 4.09 (95% CI, 2.2-7.5) compared with the uninfected group. We suggest that injecting drug use is a significant risk factor for CA-MRSA infection, which could contribute to the increasing prevalence of CA-MRSA in an urban community.
authors.affiliation: Infectious Disease, Department of Internal Medicine, University of California, Davis, Medical Center, Sacramento, CA 95817, USA.
authors.forename: Hsin
authors.initials: H
authors.lastname: Huang
authors.forename: Stuart H
authors.initials: SH
authors.lastname: Cohen
authors.forename: Jeff H
authors.initials: JH
authors.lastname: King
authors.forename: Caroline
authors.initials: C
authors.lastname: Monchaud
authors.forename: Hien
authors.initials: H
authors.lastname: Nguyen
authors.forename: Neil M
authors.initials: NM
authors.lastname: Flynn
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification*; D015819:Substance Abuse, Intravenous