2182. Pneumonia in Patients who Inhale drugs, experience in a tertiary care hospital

Abstract

Background Drug use (DU) is associated with various infectious diseases complications including pneumonia. Inhalational drug use (IHDU) associated pneumonia have not been well described. We sought to describe our experience with pneumonia associated with IHDU. Methods A retrospective chart review from 2015-2021 in a tertiary care teaching hospital. Patients (pts) diagnosed with pneumonia who reported IHDU were included. Data was collected for age, type and route of DU, comorbidities, etiological diagnosis, radiological results and outcome. Results A total of 237 pts were identified. Median age 53 years (range of 22-75), females 128 (54%). Smoking drugs in 158 (66.6%), 115 (48%) used drugs by sniffing/snorting, 19(8%) reported also active intravenous drug use (IVDU) and 16(6.7%) had a past history of IVDU. Overall 120 (50.6%) used cocaine, heroin in 78 (33.3%), while 156 (66%) used both heroin and cocaine. HIV infection in 57 (23.7%). Blood cultures were positive in 18/153: 4 Staphylococcus aureus, 2 Streptococcus pneumonia, 1 Serratia spc., 1 Pseudomonas aeruginosa. Sputum cultures were (+) in 20/69 and bronchoalveolar lavage (BAL) was (+) in 8/10, of them 7 Staphylococcus aureus, 2 Streptococcus pneumonia, 2 Klebsiella pneumonia, 2 Haemophilus influenza and 1 Pneumocystic carnii. Pneumococcal urine Ag in 3. Chest imaging was done in 228 (96%). Imaging was (+) in 192 (84.2%), infiltrates in 83 (43%), opacities in 30 (17%), consolidation in 21 (11%), 1 lung cavity and 44 (23%) had mixed findings. Negative imaging in 36 (15.8%) and no imaging in 9 (4%). In 6(2.5%) there was no imaging or cultures to diagnose pneumonia. The average length of stay was 5.8 days. Rehospitalization in 107/237 (45.1%) within 6 months of initial admission of these 43/107 (40.2%) were diagnosed with pneumonia, 74 (69%) were diagnosed with another pulmonary diagnosis. Five (2.1%) patients expired; of them 3 Had HIV and 3 were active IVDU. Conclusion In our hospital pts with IHNU diagnosed with pneumonia had an increased risk of rehospitalization within 6 months of admission. There were no predominant radiological findings or microorganism isolated. Etiological diagnosis was found in a small number of patients. Mortality rate was relatively low. Disclosures All Authors: No reported disclosures.