Screening and Decolonization Programs for Staphylococcus aureus Carriers in the Slamming-Practice Community: A New Strategy for Harm Reduction?

Slamming is a widespread sexual practice that has been occurring in our society for more than a decade now. It has emerged as a public health issue because it associates many harm and risks, mainly derived from unsafe sexual practice and intravenous drug abuse. In the recent years, an additional concern has emerged regarding the rising occurrence of multidrug-resistant bacteria within the community, particularly strains of methicillin-resistant Staphylococcus aureus (S. aureus). In this report, we present the case of a human immunodeficiency virus patient addicted to parenteral-synthetic-cathinone use in the context of slamming, which developed necrotizing fasciitis by this resistant strain. As prevention measures, assuming the inevitability of slamming practices, harm reduction programs have been developed. Implemented for years, they aim to reduce the risks of addictive behaviors. This clinical case raises the question of whether methicillin-resistant S. aureus carrier screening and consequent decolonization among people who inject drugs, and more specifically among those engaged in slamming, should be included in the daily practice as another tool of these harm reduction programs.