Laura Marks, M.D., Ph.D.
ABSTRACT:
The epidemic of invasive Staphylococcus aureus infections among people who inject drugs (PWID)
poses a significant public health and economic burden. As this epidemic continues to grow, S. aureus is now the most common pathogen causing invasive infections among PWID, posing new challenges for harm reduction specialists and clinicians alike. Compared to the medical field’s understanding of invasive staphylococcal disease in general populations, there is limited understanding of precisely how the unique features of PWID relate to their high rates of blood-stream infections (BSI). In this Longer Life application titled “Pathogenesis and molecular epidemiology of S. aureus isolates associated with invasive infections among PWID” we will investigate transmission clusters occurring among PWID and identify if skin colonization or contamination of drug use equipment plays a role in the development of invasive S. aureus infections. We will examine these topics by developing a biorepository of S. aureus strains from the blood, skin and drug preparation equipment of patients presenting with injection drug use associated staphylococcal infections along with matched control patients. We will use these strains for whole genome sequencing which will allow us to characterize sources of injection drug use associated blood-stream infections. We will identify drug use practices associated with increased risk of transmission of injection drug use related invasive staphylococcal infections. By determining etiology of injection drug use associated infections and identifying risks associated with transmission of invasive staphylococcal infections among PWID, this study will make a critical contribution to the improved care of PWID as well as to the health-care of patients at risk for invasive S. aureus infections due to other causes. A clear understanding of transmission and pathogenesis of this accelerating epidemic is urgently needed to guide public health policy and target interventions.
LAY SUMMARY:
The bacterium Staphylococcus aureus causes one of the most deadly types of bloodstream infections. Little is known about where these infections come from; whether it is from bacteria already living on the skin, or from bacteria in the environment. We propose to study people who inject drugs, who are at some of the highest risks of invasive staphylococcal infections, as well as matched control patients, to identify if bacteria recovered from the skin or the environment match those strains causing deadly bloodstream infections. Understanding the role skin colonization plays in this infection will help us to develop preventative healthcare strategies to reduce the risk of recurrent infections.
