Correlates of injection‐related wounds and skin infections amongst persons who inject drugs and use a syringe service programme: A single center study

Abstract

Risk factors associated with wounds and skin infections amongst persons who inject drugs may have changed in the era of fentanyl and now stimulant coinjection. We assessed the number of injection site wounds and skin infections and associated factors amongst 675 persons who inject drugs in a syringe services programme. Of this sample, 173 participants reported a total of 307 wounds and skin infections. Significant factors associated with increased number of wounds and skin infections were age 30 or older, female gender, ever experiencing homelessness, cocaine injection, and injecting between 5 and 10 years. Wounds and skin infections were common amongst syringe services programme clients and are associated with certain risk factors that may help to design effective interventions. Given the high prevalence of wounds in syringe services programme clients, wound care clinicians can make a significant difference and improve outcomes. We also shed light on correlates of wounds and skin infections in persons who inject drugs in order to spur further research to devise efficacious interventions for this underserved group.

Treatment experiences for skin and soft tissue infections among participants of syringe service programs in North Carolina

“…Comparable studies have found similarly high prevalence estimates [ 5 , 6 , 8 ]. Previous studies have also found injection of specific types of stimulants to be associated with increased SSTI occurrence [ 5 , 31 – 35 ]. In line with this, we found cocaine and crack-cocaine injection were associated with an increased prevalence of recent SSTI history.…”

Community-acquired skin and soft-tissue infections in people who inject drugs

“…In another study from the United Kingdom (UK), factors associated with bacterial SSTI were older age (older than 35 years), reusing needles and four or more attempts to achieve an injection [8]. Furthermore, homelessness is frequently observed in patients with IDU-associated SSTIs and is likely related to barriers to proper skin cleaning prior to injections [15 ▪▪ ,25]. These results reflect the importance of sociodemographic aspects when evaluating high-risk injection practices.…”

Wounds and Skin and Soft Tissue Infections in People Who Inject Drugs and the Utility of Syringe Service Programs in Their Management

“…PWID are faced with many health risks, including increased risk of premature mortality, HIV, hepatitis C virus (HCV), hepatitis B virus (HBV), injection-related wounds, 10 and SSTIs. 2 , 11 Wounds and SSTIs are common complications of IDU and disproportionately affect PWID.…”

“… 2 , 11 Wounds and SSTIs are common complications of IDU and disproportionately affect PWID. 4 , 10 , 12 Wounds and SSTIs in PWID may contribute further to addiction as patients seek to reduce the pain and may lead to worse outcomes ( e.g., sepsis, gangrene, amputation). 5 , 12 The synergistic provision of wound care at syringe services program (SSP) is proposed as a unique upstream access solution for this high priority population.…”

“… 16 Frequency of injection has a direct relationship with infection risk as well, 17 with reduced injection frequency leading to reduced risk of bacterial infections. 10 Type of drug injected also affects the risk of SSTI, with heroin and speedball (combined heroin and cocaine) posing a greater risk of infection and methamphetamines decreasing this risk. 18 Black tar heroin has specifically been associated with higher rates of skin infections.…”