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Volume 16, Number 9—September 2010

CME ACTIVITY

Illicit Drug Use and Risk for USA300 Methicillin-Resistant Staphylococcus aureus Infections with Bacteremia

Kristen M. KreiselComments to Author , J. Kristie Johnson, O. Colin Stine, Michelle D. Shardell, Eli N. Perencevich, Alan J. Lesse, Fred M. Gordin, Michael W. Climo, and Mary-Claire Roghmann
Author affiliations: Author affiliations: University of Maryland, Baltimore, Maryland, USA (K.M. Kreisel, J.K. Johnson, O.C. Stine, M.D. Shardell, E.N. Perencevich, M.-C. Roghmann); VA Maryland Health Care System, Baltimore (K.M. Kreisel, E.N. Perencevich, M.-C. Roghmann); VA Western New York Healthcare System, Buffalo, New York, USA (A.J. Lesse); University at Buffalo, Buffalo (A.J. Lesse); Washington DC VA Medical Center, Washington, DC, USA (F.M. Gordin); George Washington University, Washington (F.M. Gordin); Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA (M.W. Climo); Medical College of Virginia at Virginia Commonwealth University, Richmond (M.W. Climo)

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Table 3

Patient and infection characteristics for 300 veterans with Staphylococcus aureus bacteremia and association with illicit drug use at 4 Veterans Affairs medical centers, USA, 2004–2008*

Variable
Used illicit drugs,† n = 22
No illicit drug use,† n = 278
p value‡
Patient characteristics
Age, y, mean ± SD 51 ± 5 69 ± 12 <0.0001
Sex
M 20 (7) 275 (93) 0.05
F 2 (40) 3 (60)
Race
Black 16 (17) 79 (83) <0.0001
Other 6 (3) 199 (97)
Year of presentation§
Late 10 (6) 159 (94) 0.29
Early 12 (9) 119 (91)
Charlson score, mean ± SD 5.4 ± 4.1 4.7 ± 2.9 0.28
HIV infection
Yes 6 (38) 10 (62) <0.0001
No 16 (6) 268 (94)
History of colonization or infection with MRSA
Yes 5 (6) 75 (94) 0.66
No 17 (8) 203 (92)
Hospitalized in year before infection
Yes 15 (8) 180 (92) 0.75
No 7 (7) 98 (93)
Surgery in year before infection
Yes 1 (1) 108 (99) <0.0001
No 21 (11) 170 (89)
Residence in LTCF in year before infection
Yes 3 (9) 31 (91) 0.73
No 19 (7) 247 (93)
Renal failure in year before infection
Yes 14 (8) 172 (92) 0.87
No
8 (7)
106 (93)

Infection characteristics
Nosocomial infection
Yes 6 (3) 166 (97) 0.003
No 16 (13) 112 (87)
Central line at time of infection
Yes 5 (6) 78 (94) 0.59
No 17 (8) 200 (92)
Permanent hardware at time of infection
Yes 4 (5) 84 (95) 0.33
No 18 (8) 194 (92)
Source of infection
Primary 10 (8) 116 (92) 0.73
Secondary 12 (7) 162 (93)
Infection complicated by endocarditis
Yes 6 (16) 32 (84) 0.04
No 16 (6) 242 (94)
Infection complicated by pneumonia
Yes 3 (7) 42 (93) 1.00
No 19 (7) 236 (93)

*MRSA, methicillin-resistant S. aureus; LTCF, long-term care facility.
†Values are no. (%) except as indicated.
‡Calculated by using Pearson χ2 or Fisher exact tests for categorical variables, Student t test or Wilcoxon signed-rank test for continuous variables.
§Year of presentation stratified into 2 periods: early (January 1, 2004–March 31, 2006) and late (April 1, 2006–June 30, 2008).

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