Abstract
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 polysubstance 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.
Highlights
Bacterial skin and soft tissue infections (SSTI) are among the most common reasons for people who inject drugs (PWID) to seek medical care [1,2]
Data requests may be directed to the Swedish Prison and Probation Service by e-mail (Support.Statistisk@kriminalvarden.se), and the Swedish National Board of Health and Welfare by e-mail or by. Both 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
The results imply the need for increased attention to bacterial infections among PWID, in terms of clinical management, prevention and research
Summary
Bacterial skin and soft tissue infections (SSTI) are among the most common reasons for people who inject drugs (PWID) to seek medical care [1,2]. The analysis did not include respiratory/urinary tract or gastrointestinal infections For this purpose, we used registers from the Swedish criminal justice system assessing injection drug use, with linkage to national diagnostic registers. Past-30-day injecting was reported by 63 and 70 percent of primary heroin and amphetamine users, respectively [13] Both 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
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