Methamphetamine Use and Methicillin-ResistantStaphylococcus aureusSkin Infections

Adam L Cohen,Katie Arnold,Daniel Jernigan,Michael G Brown,Linda K Mcdougal,Gregory E Fosheim,Carrie Shuler,Karen Anderson,Cherie Drenzek,Sigrid Mcallister,Debra Abercrombie,Rachel Gorwitz

doi:10.3201/eid1311.070148

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) infections and methamphetamine use are emerging public health problems. We conducted a case-control investigation to determine risk factors for MRSA skin and soft tissue infections (SSTIs) in residents of a largely rural southeastern community in the United States. Case-patients were persons >12 years old who had culturable SSTIs; controls had no SSTIs. Of 119 SSTIs identified, 81 (68.1%) were caused by MRSA. Methamphetamine use was reported in 9.9% of case-patients and 1.8% of controls. After we adjusted for age, sex, and race, patients with MRSA SSTIs were more likely than controls to have recently used methamphetamine (odds ratio 5.10, 95% confidence interval 1.55-16.79). MRSA caused most SSTIs in this population. Transmission of MRSA may be occurring among methamphetamine users in this community.

Highlights

Methicillin-resistant Staphylococcus aureus (MRSA) infections and methamphetamine use are emerging public health problems
For 1 methamphetamine user with MRSA soft tissue infections (SSTIs), we could not determine the route of drug administration
In our study population, having had a skin infection within the previous 3 months was the factor most strongly associated with current MRSA skin infection (AOR 7.92, 95% CI 4.10–15.28) (Table 2)

Summary

Methods

Epidemiologic Investigation We conducted a prospectively enrolled case–control investigation at 3 emergency departments and 3 urgent care clinics in Georgia from September 6 through October 31, 2005. Each patient was asked a specific question about methamphetamine use: “In the past 3 months, have you used methamphetamine (crystal meth or meth)?” If the patient answered yes, 2 follow-up questions were asked: 1) “How did you take methamphetamine?” with the choices “smoked or inhaled,” “injected,” or “swallowed or took pills,” and 2) “Have you shared drug equipment or rinse water with anyone else, including a significant other?” To identify healthcare exposure, patients were asked whether they had had surgery or dialysis or if they had stayed overnight in a hospital within the previous 3 months All patients, and their parents if the patients were

Results

Bathe less than daily

Laboratory Investigation the highest reported rates of MRSA in SSTI nationwide

Toxin gene presence