Anthrax in injecting drug users: the need for increased vigilance in the clinic

Ascough, Stephanie; Altmann, Daniel M.

doi:10.1586/14787210.2015.1032255

Cited by 13 publications

(13 citation statements)

References 29 publications

(42 reference statements)

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“…Two species, B. anthracis and B. cereus , are clinically significant pathogens, causing anthrax and nausea and diarrhea, respectively [2]. Anthrax is classically characterized into three forms of disease, cutaneous, gastrointestinal, and inhalational anthrax, each with different fatality rates [3, 4]. Recently, a new infection route, described as injectional anthrax, has been associated with nonspecific symptoms and high fatality rates in sporadic outbreaks among drug users in Europe [4].…”

Section: Introductionmentioning

confidence: 99%

“…Anthrax is classically characterized into three forms of disease, cutaneous, gastrointestinal, and inhalational anthrax, each with different fatality rates [3, 4]. Recently, a new infection route, described as injectional anthrax, has been associated with nonspecific symptoms and high fatality rates in sporadic outbreaks among drug users in Europe [4]. Cutaneous anthrax usually results from contact with infected animals and it is the most common infection route [3, 4].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, a new infection route, described as injectional anthrax, has been associated with nonspecific symptoms and high fatality rates in sporadic outbreaks among drug users in Europe [4]. Cutaneous anthrax usually results from contact with infected animals and it is the most common infection route [3, 4]. Gastrointestinal anthrax is rare and is usually acquired through consumption of contaminated food [3, 4].…”

Section: Introductionmentioning

confidence: 99%

“…Cutaneous anthrax usually results from contact with infected animals and it is the most common infection route [3, 4]. Gastrointestinal anthrax is rare and is usually acquired through consumption of contaminated food [3, 4]. Inhalational anthrax is recognized as the most severe form of the disease and it has to be treated urgently for any chance of survival, with mortality rates approaching 100% if untreated [3, 4].…”

Section: Introductionmentioning

confidence: 99%

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Penicillin-Susceptible, Oxidase-Negative, Nonhemolytic, NonmotileBacillus megateriumin Disguise ofBacillus anthracis

Loong

Teoh

Johari

et al. 2017

Case Reports in Infectious Diseases

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Bacillus anthracis is a bacterial pathogen of major concern. The spores of this bacteria can survive harsh environmental conditions for extended periods and are well recognized as a potential bioterror weapon with significant implications. Accurate and timely identification of this Bacillus species in the diagnostic laboratory is essential for disease and public health management. Biosafety Level 3 measures and ciprofloxacin treatment were instituted when B. anthracis was suspected from a patient with gangrenous foot. 16S rDNA sequencing was performed to accurately identify the suspected bacterium, due to the superiority of this method to accurately identify clinically isolated bacteria. B. megaterium was identified as the causative agent and the organism was subsequently treated as a Biosafety Level 2 pathogen.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Penicillin-Susceptible, Oxidase-Negative, Nonhemolytic, NonmotileBacillus megateriumin Disguise ofBacillus anthracis

Loong

Teoh

Johari

et al. 2017

Case Reports in Infectious Diseases

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“…As mentioned above, the main cause of infections with Bacillus and Clostridium species is contaminated heroin [3–5, 11]. The ‘street’ process for preparing brown heroin includes the use of acidic substrates such as citric acid in water and flame heating [7].…”

Section: Introductionmentioning

confidence: 99%

Development of a filter to prevent infections with spore-forming bacteria in injecting drug users

Alhusein¹,

Scott²,

Kasprzyk-Hordern

et al. 2016

Harm Reduct J

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BackgroundIn heroin injectors, there have been a number of outbreaks caused by spore-forming bacteria, causing serious infections such as anthrax or botulism. These are, most likely, caused by injecting contaminated heroin, and our aim was to develop a filter that efficiently removes these bacteria and is also likely to be acceptable for use by people who inject drugs (i.e. quick, simple and not spoil the hit).MethodsA prototype filter was designed and different filter membranes were tested to assess the volume of liquid retained, filtration time and efficiency of the filter at removing bacterial spores. Binding of active ingredients of heroin to different types of membrane filters was determined using a highly sensitive analytical chemistry technique.ResultsHeroin samples that were tested contained up to 580 bacteria per gramme, with the majority being Bacillus spp., which are spore-forming soil bacteria. To remove these bacteria, a prototype filter was designed to fit insulin-type syringes, which are commonly used by people who inject drugs (PWIDs). Efficient filtration of heroin samples was achieved by combining a prefilter to remove particles and a 0.22 μm filter to remove bacterial spores. The most suitable membrane was polyethersulfone (PES). This membrane had the shortest filtration time while efficiently removing bacterial spores. No or negligible amounts of active ingredients in heroin were retained by the PES membrane.ConclusionsThis study successfully produced a prototype filter designed to filter bacterial spores from heroin samples. Scaled up production could produce an effective harm reduction tool, especially during outbreaks such as occurred in Europe in 2009/10 and 2012.Electronic supplementary materialThe online version of this article (doi:10.1186/s12954-016-0122-1) contains supplementary material, which is available to authorized users.

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Occurrence of bacterial and toxic metals contamination in illegal opioid-like drugs in Iran: a significant health challenge in drug abusers

et al. 2018

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Anthrax in injecting drug users: the need for increased vigilance in the clinic

Cited by 13 publications

References 29 publications

Penicillin-Susceptible, Oxidase-Negative, Nonhemolytic, NonmotileBacillus megateriumin Disguise ofBacillus anthracis

Penicillin-Susceptible, Oxidase-Negative, Nonhemolytic, NonmotileBacillus megateriumin Disguise ofBacillus anthracis

Development of a filter to prevent infections with spore-forming bacteria in injecting drug users

Occurrence of bacterial and toxic metals contamination in illegal opioid-like drugs in Iran: a significant health challenge in drug abusers

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