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Epidemic Spread of a Single Clone of Methicillin-Resistant Staphylococcus aureus among Injection Drug Users in Zurich, Switzerland

Fleisch, Felix ; Zbinden, Reinhard ; Vanoli, Claudia ; Ruef, Christian

In: Clinical Infectious Diseases, 2001, vol. 32, no. 4, p. 581-586

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    Title
    • Epidemic Spread of a Single Clone of Methicillin-Resistant Staphylococcus aureus among Injection Drug Users in Zurich, Switzerland
    Author
    • Fleisch, Felix. Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Switzerland
    • Zbinden, Reinhard. Department of Medical Microbiology, University of Zurich, Switzerland
    • Vanoli, Claudia. Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Switzerland
    • Ruef, Christian. Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Clinical Infectious Diseases, 2001, vol. 32, no. 4, p. 581-586. The University of Chicago Press
    Other Version
    Classification
    • Health
    OAI-PMH Identifier
    • oai:doc.rero.ch:289246
    Summary
    We describe an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) among injection drug users (IDUs). From August 1994 through December 1999, we registered 31 IDUs with MRSA infections (12 with soft-tissue infection, 7 with pneumonia [fatal in 1], 7 with endocarditis [fatal in 1], 2 with osteomyelitis, 2 with septic arthritis, and 1 with ulcerative tonsillitis), with a marked increase in the number of IDUs registered during 1998 and 1999. Of 31 patients, 15 (48%) were infected with human immunodeficiency virus. A point-prevalence study among IDUs who frequented outpatient facilities in Zurich revealed an MRSA carriage rate of 10.3% (range, 0%-28.6%) in various facilities. In all but 1 case, pulsed-field gel electrophoresis banding patterns of isolates obtained from these patients were indistinguishable from isolates of the initial 31 IDUs registered. Risk factors for MRSA carriage were disability and prior hospitalization in a hospice. In summary, MRSA became endemic in IDUs in Zurich as a result of the spread of a single clone. This clone caused major morbidity and was responsible for a lethal outcome in 2 cases