title: High Perineal and Overall Frequency of Staphylococcus aureus in People Who Inject Drugs, Compared to Non-Injectors.
abstract: To investigate the prevalence, distribution, and colonization burden of Staphylococcus aureus (S. aureus) and MRSA in different body sites among people who inject drugs (PWID) and compare it to a control group consisting of non-injectors. In this cross-sectional survey, 49 active PWID from the needle exchange program (NEP) in Malmö, Sweden, and 60 non-injecting controls from an emergency psychiatric inpatient ward at Malmö Addiction Centre were tested for S. aureus (including MRSA) by culture, PCR, and MALDI-TOF. Samples were taken from anterior nares, throat, perineum, and skin lesions if present. Sixty-seven percent of the PWID were colonized with S. aureus, compared to 50% of the controls (P = 0.08). Perineal carriage was significantly more frequent among PWID than in the control group [37 vs 17%, OR 2.96 (95% CI 1.13-7.75), P = 0.03], also after adjusting for sex and age in multivariate analysis [OR 4.01 (95% CI 1.34-12.03)]. Only one individual in the whole cohort (NEP participant) tested positive for MRSA. PWID may be more frequently colonized with S. aureus in the perineum than non-injection drug users, and there was a trend indicating more frequent overall S. aureus colonization in PWID, as well as higher perineal colonization burden. No indication of a high MRSA prevalence among PWID in Sweden was noted. However, further MRSA prevalence studies among PWID are needed. Knowledge about S. aureus colonization is important for the prevention of S. aureus infections with high morbidity in PWID.
authors.affiliation: Division of Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden. disa.dahlman@med.lu.se.|Clinical Research Unit, Malmö Addiction Centre, Skåne University Hospital, Södra Förstadsg 35, Plan 4, 205 02, Malmö, Sweden. disa.dahlman@med.lu.se.
authors.forename: Disa
authors.initials: D
authors.lastname: Dahlman
authors.affiliation: School of Medicine, Örebro University, Örebro, Sweden.
authors.forename: Farnaz
authors.initials: F
authors.lastname: Jalalvand
authors.affiliation: Infectious Disease Research Unit, Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden.
authors.forename: Marianne Alanko
authors.initials: MA
authors.lastname: Blomé
authors.affiliation: Division of Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.|Clinical Research Unit, Malmö Addiction Centre, Skåne University Hospital, Södra Förstadsg 35, Plan 4, 205 02, Malmö, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Håkansson
authors.affiliation: Clinical Microbiology, Central Hospital, Växjö, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Janson
authors.affiliation: Infectious Disease Research Unit, Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden.
authors.forename: Susanne
authors.initials: S
authors.lastname: Quick
authors.affiliation: Infectious Disease Research Unit, Department of Clinical Sciences, Skåne University Hospital, Malmö, Sweden.
authors.forename: Anna C
authors.initials: AC
authors.lastname: Nilsson
mesh_terms: D001431:Bacteriological Techniques / Q000379:methods; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D003430:Cross-Sectional Studies; D006801:Humans; D009297:Nasal Mucosa / Q000382:microbiology; D010502:Perineum / Q000382:microbiology; D010614:Pharynx / Q000382:microbiology; D016133:Polymerase Chain Reaction; D015995:Prevalence; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013548:Sweden / Q000453:epidemiology