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ORIGINAL RESEARCH ARTICLE

Community-Acquired Methicillin-Resistant Staphylococcus aureus (CA-MRSA) Colonization and Infection in Intravenous and Inhalational Opiate Drug Abusers

Amany El-Sharif^* and Hossam M. Ashour^,1

^* Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt; and Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt

To whom requests for reprints should be addressed at ¹ Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Kasr El-Aini Street, Cairo, Cairo 11562, Egypt. E-mail: hossamking{at}mailcity.com

Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen in hospital-acquired and community-acquired infections. We hypothesized that drug abuse is a risk factor for community-acquired MRSA (CA-MRSA) infection, and we employed a rapid multiplex PCR technique for MRSA identification. The study was conducted on MRSA isolates from 60 opiate addicts (intravenous and inhalational drug users) to detect the rate and location of MRSA colonization and infection among them in comparison to 60 non-addict patients and 15 healthy volunteer controls. The proportion of addicts with MRSA colonization (and/or infection) was significantly higher than non-addict patients with MRSA colonization. MRSA colonization was associated with infection in 58% of MRSA-colonized addicts. The MRSA nasal carriage in the addicts was significantly higher than MRSA carriage elsewhere, whether in the addicts group or in the non-addict patients group. Moreover, the nasopharyngeal carriage rate of MRSA among addicts was significantly higher than among the non-addict patients. Increasing the duration of addiction resulted in a significant increase in CA-MRSA colonization in opiate addicts. Both inhalational and intravenous drug use led to significant MRSA colonization in the addict population. In conclusion, this study demonstrated how drug abusers, a high-risk group for infections with MRSA, could be a source or a reservoir of CA-MRSA infection in the non-addict population.

Key Words: MRSA • community • opiate • infection • colonization