Abstract
BackgroundInfections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs). Syringe exchange programs are currently prohibited by law in Florida. The goal of this study was to estimate the mortality and cost of injection drug use-related bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. Additionally, the prevalence of HIV and hepatitis C virus among this cohort of hospitalized IDUs was estimated.Methods and FindingsIDUs discharged from Jackson Memorial Hospital were identified using the International Classification of Diseases, Ninth Revision, codes for illicit drug abuse and endocarditis, bacteremia or sepsis, osteomyelitis and skin and soft tissue infections (SSTIs). 349 IDUs were identified for chart abstraction and 92% were either uninsured or had publicly funded insurance. SSTIs, the most common infection, were reported in 64% of IDUs. HIV seroprevalence was 17%. Seventeen patients (4.9%) died during their hospitalization. The total cost for treatment for injection drug use-related infections to Jackson Memorial Hospital over the 12-month period was $11.4 million.ConclusionsInjection drug use-related bacterial infections represent a significant morbidity for IDUs in Miami-Dade County and a substantial financial cost to the county hospital. Strategies aimed at reducing risk of infections associated with injection drug use could decrease morbidity and the cost associated with these common, yet preventable infections.
Highlights
Miami-Dade County ranks first in the United States in new HIV infections [1]
Injection drug use-related bacterial infections represent a significant morbidity for injection drug users (IDUs) in Miami-Dade County and a substantial financial cost to the county hospital
Cost of Hospitalizations for Infections Related to IDU in Miami
Summary
Estimates of HIV prevalence among injection drug users (IDUs) in Miami range from 14% to 23% [2,3]. The use of dirty needles and failure to disinfect the skin before injection can increase the risk of infections [9,10]. Infections related to injection drug use are common. Harm reduction strategies such as syringe exchange programs and skin care clinics aim to prevent these infections in injection drug users (IDUs). The goal of this study was to estimate the mortality and cost of injection drug userelated bacterial infections over a 12-month period to the county safety-net hospital in Miami, Florida. The prevalence of HIV and hepatitis C virus among this cohort of hospitalized IDUs was estimated.
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