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Arch Intern Med. 2002 Mar 11;162(5):517-22.

Clostridial myonecrosis cluster among injection drug users: a molecular epidemiology investigation.

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Epidemiology and Prevention Interventions Center, Box 1372, Room 301, Bldg 100, San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110, USA.


A molecular epidemiologic investigation was performed on a cluster of severe necrotizing Clostridium infections in 5 injection drug users admitted to an urban community hospital. Interviews with survivors suggested a point source of infection. Pulsed-field gel electrophoresis of SmaI restriction digests was performed to determine the molecular relatedness of clinically obtained isolates and isolates obtained from heroin samples and the home environment. A common clonal strain was found in Clostridium sordellii isolates from 2 socially unrelated patients and from drug paraphernalia. Clonality of a Clostridium perfringens strain from another patient isolate was identical to an isolate from a syringe found in her home. Other C perfringens isolates from patients, heroin, and the environment were determined to be polyclonal. We postulate that rapid recognition and public health notification led to rapid resolution of the outbreak.

[Indexed for MEDLINE]

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