Reply to Dr. Charlebois et al. ( Clin Infect Dis 2002; 34:425–33 )

Abstract

Sir—In their study of the community prevalence of carriage of methicillin-resistant Staphylococcus aureus (MRSA) among San Francisco's urban poor, Charlebois et al. [1] found an overall prevalence of MRSA carriage of 2.8%. Injection drug use and prior hospitalization within 1 year were significant multivariate risk factors for MRSA acquisition. During the spring of 2000, a similar point prevalence study of MRSA nasal carriage among injection drug users (IDUs) in the downtown east side of Vancouver, British Columbia, was conducted jointly by the Communicable Disease Control Division of the Vancouver/Richmond Health Board and the Division of Medical Microbiology and Infection Control, Vancouver Hospital and Health Sciences Centre (VHHSC). Vancouver has a large concentration of economically disadvantaged individuals in the downtown east side of the city core. This inner-city neighborhood is home to 47,940 people, 52% of whom live below the poverty level. The life expectancy for men is 65.8 years, compared with 79.9 years in Vancouver's wealthiest neighborhood [2]. The area provides services for 12,000 IDUs, many of whom live in the area's ∼500 single-room–occupancy hotels [3]. Approximately 3,000,000 needles are dispensed annually through the needle-exchange program [4].