Both localized and systemic bacterial infections are predicted by injection drug use: A prospective follow-up study in Swedish criminal justice clients
Both localized and systemic bacterial infections are predicted by injection drug use: A prospective follow-up study in Swedish criminal justice clients
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DOI：
10.1371/journal.pone.0196944
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发表时间：
2018-05-31
期刊：
影响因子：
3.7
通讯作者：
Hakansson, Anders
中科院分区：
文献类型：
--
作者：
Dahlman, Disa;Berge, Jonas;Hakansson, Anders
皮肤和软组织感染（SSTI）和全身性细菌感染（PWID）在注射毒品的人群中很常见，但缺乏关于发病率和危险因素的数据。我们比较了在瑞典的刑事司法客户的这种感染的登记诊断方面注射druguse.MethodsBaseline采访数据从瑞典监狱和缓刑服务的药物使用在PWID和非PWID有问题的酒精使用的后续数据从瑞典国家登记的医院诊断和/或死亡。药物的使用和以后的诊断SSTI和全身性细菌感染（败血症或细菌感染的心脏，骨/关节或中枢神经系统）之间的关联进行了分析考克斯regression. ResultsSTI的发病率为28.3每1,000人年的PWID（n = 2,444）和10.0的非PWID有问题的酒精使用（n = 735）。全身细菌感染的发生率为9.1/1000人-年，PWID和2.7/1000人-年，非PWID。注射药物使用与细菌感染风险显著增加相关，主要药物为海洛因（SSTI：风险比[HR] 2.45;全身感染：HR 2.75）、苯丙胺（SSTI：HR 1.60;全身感染：HR 2.19）和多种物质使用（SSTI：HR 1.92;全身感染：HR 2.01）。在有关注射使用苯丙胺和多物质的使用，PWID主要使用海洛因有较高的风险SSTI.ConclusionsInjection毒品使用预测SSTI和全身细菌感染，特别是高风险的SSTI在PWID主要使用海洛因。这些结果意味着需要在临床管理、预防和研究方面增加对PWID中细菌感染的关注。
BackgroundBoth skin and soft tissue infections (SSTI) and systemic bacterial infections are common in people who inject drugs (PWID), but data on incidence and risk factors are lacking. We compared registered diagnoses for such infections in Swedish criminal justice clients with regard to injecting drug use.MethodsBaseline interview data from the Swedish Prison and Probation Service on drug use in PWID and non-PWID with problematic alcohol use were linked to follow-up data from national Swedish registers on hospital diagnoses and/or death. Associations between drug use and later diagnosis of SSTI and systemic bacterial infection (septicemia or bacterial infection of the heart, bone/joints or central nervous system) were analyzed by Cox regression.ResultsIncidence rates of SSTI was 28.3 per 1,000 person-years for PWID (n = 2,444) and 10.0 for non-PWID with problematic alcohol use (n = 735). Incidence rates of systemic bacterial infection was 9.1 per 1,000 person-years for PWID and 2.7 per 1,000 person-years for non-PWID. Injection drug use was associated with a significantly increased risk of bacterial infections, for main drugs heroin (SSTI: Hazard ratio [HR] 2.45; systemic infection: HR 2.75), amphetamine (SSTI: HR 1.60; systemic infection: HR 2.19), and polysubstance use (SSTI: HR 1.92; systemic infection: HR 2.01). In relation to injection use of amphetamine and poly substance use, PWID mainly using heroin had higher risk of SSTI.ConclusionsInjection drug use predicted both SSTI and systemic bacterial infection, with a particularly high risk of SSTI in PWID mainly using heroin. The results imply the need for increased attention to bacterial infections among PWID, in terms of clinical management, prevention and research.