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. 2020 Mar;26(3):446-453.
doi: 10.3201/eid2603.191408.

Methicillin-Resistant Staphylococcus aureus Bloodstream Infections and Injection Drug Use, Tennessee, USA, 2015-2017

Meghana P Parikh, Rany Octaria, Marion A Kainer

Methicillin-Resistant Staphylococcus aureus Bloodstream Infections and Injection Drug Use, Tennessee, USA, 2015-2017

Meghana P Parikh et al. Emerg Infect Dis. 2020 Mar.

Abstract

Recently, Tennessee, USA, has seen an increase in the use of commonly injected drugs, such as heroin and fentanyl. Injection drug use (IDU) practices can lead to life-threatening methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (BSIs) and other serious diseases. We matched MRSA BSIs identified through the National Healthcare Safety Network to the Tennessee Hospital Discharge Data System to characterize the prevalence, demographics, and clinical characteristics associated with IDU in this disease population. Of the 7,646 MRSA BSIs identified during 2015-2017, we found that 1,839 (24.1%) were IDU-related. IDU-related BSIs increased by 118.9%; the greatest rise occurred among emergency department-onset infections (197.4%). IDU was more often associated with white, female, 18-49-year-old, and uninsured persons (p<0.001). We found >1 additional IDU-related diagnoses in 84.2% of IDU-related BSIs. Targeted harm reduction strategies for persons at high risk of IDU are necessary to reduce MRSA BSIs in acute care settings.

Keywords: MRSA; Methicillin-resistant Staphylococcus aureus; Tennessee; United States; antimicrobial resistance; bacteria; endocarditis; hepatitis C; illicit drugs.

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Figures

Figure
Figure
Annual cases of methicillin-resistant Staphylococcus aureus bloodstream infections in hospitals, stratified by onset type, Tennessee, USA, 2015–2017. CO, community onset; ED, emergency department; HO, hospital onset; IP, inpatient.
See this image and copyright information in PMC

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