ArticleEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin2019
Clonal expansion of community-associated meticillin-resistant Staphylococcus aureus (MRSA) in people who inject drugs (PWID): prevalence, risk factors and molecular epidemiology, Bristol, United Kingdom, 2012 to 2017.
Article in Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Harms associated with injecting in public spaces: a global systematic review and meta-analysis.The International journal on drug policy · 2025Pooled it
- Bacterial Carriage and Invasive Infections Among People Who Inject Drugs: Clinical and Molecular Epidemiology in an Australian Prospective Cohort.Open forum infectious diseases · 2026Article
- Bacterial and fungal infections in persons who inject drugs.Clinical microbiology reviews · 2025Review
- The Clinical and Molecular Characteristics of Community-AssociatedOpen forum infectious diseases · 2025Article
- Risk Factors for Infective Endocarditis and Serious Injection Related Infections Among People Who Inject Drugs in Los Angeles, CA and Denver, CO.Drug and alcohol dependence · 2025Article
- Clinical Features and Antibiotic Susceptibility ofJournal of clinical medicine · 2025Article
- Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder.Harm reduction journal · 2024Article
- Clinical impact and public health challenges of a PVL-MRSA bacteraemia outbreak amongst people who inject drugs in South Yorkshire, UK.Access microbiology · 2024Article
- Everything but the Kitchen Sink: An Analysis of Bacterial and Chemical Contaminants Found in Syringe Residue From People Who Inject Drugs.Open forum infectious diseases · 2024Article
- Epidemiology of acute infections in people who inject drugs in Australia.Drug and alcohol review · 2024Review
- Outbreak investigation including molecular characterization of community associated methicillin-resistant Staphylococcus aureus in a primary and secondary school in Eastern Switzerland.Scientific reports · 2022Article
- Severe bacterial infections in people who inject drugs: the role of injection-related tissue damage.Harm reduction journal · 2022Article
- Panorama of Bacterial Infections Caused by Epidemic Resistant Strains.Current microbiology · 2022Review
- Genomic epidemiology of methicillin-resistant and -susceptible Staphylococcus aureus from bloodstream infections.BMC infectious diseases · 2021Article
- A two-component intervention to improve hand hygiene practices and promote alcohol-based hand rub use among people who inject drugs: a mixed-methods evaluation.BMC infectious diseases · 2021Article
- Article
- Incidence and treatment costs of severe bacterial infections among people who inject heroin: A cohort study in South London, England.Drug and alcohol dependence · 2020Article
- Antibacterial Effect and Mode of Action of Flavonoids From Licorice Against Methicillin-ResistantFrontiers in microbiology · 2019Article
Corrections and comments
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Authors and funding
18 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundIn 2015, Bristol (South West England) experienced a large increase in cases of meticillin-resistant
aimWe aimed to characterise and estimate the prevalence of MRSA colonisation among PWID in Bristol and test evidence of a clonal outbreak.
methodsPWID recruited through an unlinked-anonymous community survey during 2016 completed behavioural questionnaires and were screened for MRSA. Univariable logistic regression examined associations with MRSA colonisation. Whole-genome sequencing used lineage-matched MRSA isolates, comparing PWID (screening and retrospective bacteraemia samples from 2012-2017) with non-PWID (Bristol screening) in Bristol and national reference laboratory database samples.
resultsThe MRSA colonisation prevalence was 8.7% (13/149) and was associated with frequently injecting in public places (odds ratio (OR): 5.5; 95% confidence interval (CI):1.34-22.70), recent healthcare contact (OR: 4.3; 95% CI: 1.34-13.80) and injecting in groups of three or more (OR: 15.8; 95% CI: 2.51-99.28). People reporting any one of: injecting in public places, injection site skin and soft tissue infection or hospital contact accounted for 12/13 MRSA positive cases (sensitivity 92.3%; specificity 51.5%). Phylogenetic analysis identified a dominant clade associated with infection and colonisation among PWID in Bristol belonging to ST5-SCCmecIVg.
conclusionsMRSA colonisation in Bristol PWID is substantially elevated compared with general population estimates and there is evidence of clonal expansion, community-based transmission and increased infection risk related to the colonising strain. Targeted interventions, including community screening and suppression therapy, education and basic infection control are needed to reduce MRSA infections in PWID.
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Registered trials
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