Abstract
Injecting drug use became during last decade a major health public issue, both in Romania and around the world. Incidence of HIV and viral hepatitis in injecting drug users (IDUs) has dramatically increased due to the appearance of new highly addictive drugs (called “ethnobotanicals”) with unknown effects and associated with increased use of unsterile injecting equipment. Severe bacterial infections with poor outcome often complicate the clinical evolution of these patients, especially in case of severe immunosuppression secondary to HIV. We will describe in this review the most common bacterial infections developed due to injecting drug use. Bacterial endocarditis in IDUs are usually right-sided, Staphylococcus aureus being the most common pathogen. These patients also develop skin/soft tissues and respiratory tract infections (due to altered local defense mechanisms), as well as sexually transmitted diseases due to high risk sexual behavior, usually determined by recreational drug use. This behavior is known as “ChemSEX” and is usually practiced by men having sex with men. There were also reported cases of wound botulism, tetanus and even anthrax epidemics among IDUs. HIV infected IDUs usually require complex management with multidisciplinary approach and sometimes surgical treatment.
Highlights
Injecting drug use became during last decade a major health public issue, both in Romania and around the world
injecting drug users (IDUs) have often high risk behavior, having multiple partners and unprotected sexual intercourses with occasional partners, which is the case in MSM patients [5]. Both Romania and Greece have raised attention regarding injecting drug use in 2011 when the increased number of HIV cases was reported among IDUs from this region [4]
Left-sided endocarditis, with other etiology than Methicillin-sensitive Staphylococcus aureus (MSSA) are usually associated with poor outcome, high risk of complications and high mortality rates
Summary
Even if there are multiple ways of using drugs, intravenous administration has became a particular issue worldwide during the last decade, being an important challenge for authorities due to its economic, social and legal implications. IDUs have often high risk behavior, having multiple partners and unprotected sexual intercourses with occasional partners, which is the case in MSM (men having sex with men) patients [5] Both Romania and Greece have raised attention regarding injecting drug use in 2011 when the increased number of HIV cases was reported among IDUs from this region [4]. In addition to the amphetamine-like stimulant effects, a high number of IDUs considered these drugs safer and started using them trying to avoid heroin addiction Due to their short half-life time, ethnobotanical drugs require multiple injections per day (6 - 10), a an increased risk of unsterile injecting equipment use and needle sharing, and as a consequence, a higher rate of transmission of parenteral infections. A high number of opioid addicts tried to switch from heroin and use ethnobotanical drugs, but ended up by being addicted to both of them [10,11,12]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
