Predictors of skin and soft tissue infections among sample of rural residents who inject drugs.
Predictors of skin and soft tissue infections among sample of rural residents who inject drugs.
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注入药物的农村居民样本中皮肤和软组织感染的预测因子。
DOI：
10.1186/s12954-020-00447-3
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发表时间：
2020-12-02
影响因子：
4.4
通讯作者：
Brown R
中科院分区：
文献类型：
--
作者：
Baltes A;Akhtar W;Birstler J;Olson-Streed H;Eagen K;Seal D;Westergaard R;Brown R
皮肤和软组织感染(SSTI)是注射吸毒者(PWID)发病和死亡的主要原因之一。研究表明，某些注射方法与PWID中SSTI的发生率相关。阿片类药物在美国的流行尤其影响到农村社区，在那里获得预防和治疗是一个独特的挑战。这项研究旨在评估农村居民中不安全的注射行为；评估用于注射相关SSTI的治疗；并收集数据以帮助降低注射相关SSTI的总体风险。针对SSTI和注射做法的13个问题被添加到一项更大的研究中，评估PWID中未得到满足的医疗保健需求，并在2019年5月至7月期间在威斯康星州农村的六个注射器交换项目中进行。根据应答前一年内报告的感染情况估计SSTI病史流行率，并与自我报告的人口统计学和注射方法进行比较。收集了80份回复并进行了分析。受访者为白人(77.5%)，男性(60%)，年龄在30岁至39岁之间(42.5%)，拥有高中文凭或GED(38.75%)。大多数受访者(77.5%)报告在调查答复前一年内没有SSTI病史。女性报告性传播感染病史的可能性是男性的三倍多(OR = 3.07，p = 0.038)。药物稀释的水源(p = 0.093)和第一次注射的频率(p = 0.037)，但没有正确的皮肤清洁方法(p = 0.378)与性传播感染的病史显著相关。皮肤注射(p = 0.038)或肌肉注射(p = 0.001)与系统性红斑狼疮病史显著相关。静脉注射与SSI无显著相关性(p = 0.333)。在这个农村样本中，高风险注射做法在报告SSTI病史的参与者中很常见。有必要进行研究，探讨影响高风险注射做法的社会人口因素以及预防SSTI的更安全注射做法的一般障碍。在未接受治疗的PWID中传播针对SSTI预防和干预的教育材料是必要的。
Skin and soft tissue infections (SSTIs) are among the leading causes of morbidity and mortality for people who inject drugs (PWID). Studies demonstrate that certain injection practices correlate with SSTI incidence among PWID. The opioid epidemic in the USA has particularly affected rural communities, where access to prevention and treatment presents unique challenges. This study aims to estimate unsafe injection practices among rural-dwelling PWID; assess treatments utilized for injection related SSTIs; and gather data to help reduce the overall risk of injection-related SSTIs. Thirteen questions specific to SSTIs and injection practices were added to a larger study assessing unmet health care needs among PWID and were administered at six syringe exchange programs in rural Wisconsin between May and July 2019. SSTI history prevalence was estimated based on infections reported within one-year prior of response and was compared to self-reported demographics and injection practices. Eighty responses were collected and analyzed. Respondents were white (77.5%), males (60%), between the ages 30 and 39 (42.5%), and have a high school diploma or GED (38.75%). The majority of respondents (77.5%) reported no history of SSTI within the year prior to survey response. Females were over three times more likely to report SSTI history (OR = 3.07, p = 0.038) compared to males. Water sources for drug dilution (p = 0.093) and frequency of injecting on first attempt (p = 0.037), but not proper skin cleaning method (p = 0.378), were significantly associated with a history of SSTI. Injecting into skin (p = 0.038) or muscle (p = 0.001) was significantly associated with a history of SSTI. Injection into veins was not significantly associated with SSTI (p = 0.333). Higher-risk injection practices were common among participants reporting a history of SSTIs in this rural sample. Studies exploring socio-demographic factors influencing risky injection practices and general barriers to safer injection practices to prevent SSTIs are warranted. Dissemination of education materials targeting SSTI prevention and intervention among PWID not in treatment is warranted.
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