Hospitalizations for Endocarditis and Associated Health Care Costs Among Persons with Diagnosed Drug Dependence — North Carolina, 2010–2015

Fleischauer, Aaron; Ruhl, Laura J; Rhea, Sarah; Barnes, Erin

doi:10.15585/mmwr.mm6622a1

Cited by 138 publications

(95 citation statements)

References 9 publications

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“…Of note, Stewart et al (190) reported a case series of 10 patients treated with oritavancin, including 1 patient with NVE due to group B Streptococcus, who unfortunately failed treatment. Although oritavancin is currently indicated only for acute bacterial skin and skin structure infections, it has the potential to play an increasing role as an agent against MRSA PVE, particularly in light of the ongoing international opioid epidemic (191,192).…”

Section: Alternative Therapiesmentioning

confidence: 99%

Methicillin-Resistant Staphylococcus aureus Prosthetic Valve Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management

et al. 2019

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SUMMARY Staphylococcus aureus prosthetic valve endocarditis (PVE) remains among the most morbid bacterial infections, with mortality estimates ranging from 40% to 80%. The proportion of PVE cases due to methicillin-resistant Staphylococcus aureus (MRSA) has grown in recent decades, to account for more than 15% of cases of S. aureus PVE and 6% of all cases of PVE. Because no large studies or clinical trials for PVE have been published, most guidelines on the diagnosis and management of MRSA PVE rely upon expert opinion and data from animal models or related conditions (e.g., coagulase-negative Staphylococcus infection). We performed a review of the literature on MRSA PVE to summarize data on pathogenic mechanisms and updates in epidemiology and therapeutic management and to inform diagnostic strategies and priority areas where additional clinical and laboratory data will be particularly useful to guide therapy. Major updates discussed in this review include novel diagnostics, indications for surgical management, the utility of aminoglycosides in medical therapy, and a review of newer antistaphylococcal agents used for the management of MRSA PVE.

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Section: Alternative Therapiesmentioning

confidence: 99%

Methicillin-Resistant Staphylococcus aureus Prosthetic Valve Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management

et al. 2019

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“…As a consequence, approximately 16% of cases of IE in North America are now attributable to IDU [2]. In North Carolina, there was a 12-fold increase in hospitalization related to injection drug use–associated IE (IDU-IE) from 2010 to 2015, with the hospital costs for managing those infections exceeding $22 million by 2015 [3]. Not surprisingly, IE has been identified as 1 of the infections of concern in relation to the opioid crisis [4].…”

mentioning

confidence: 99%

Repeat Infective Endocarditis in Persons Who Inject Drugs: “Take Another Little Piece of my Heart”*

Huang

Barnes

Peacock

2018

Open Forum Infectious Diseases

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BackgroundInjection drug use (IDU) is a major risk factor for infective endocarditis (IE). Few data exist on repeat IE (rIE) in persons who inject drugs (PWID).MethodsPatients ≥18 years old seen at Wake Forest Baptist Medical Center from 2004 to 2017 who met Duke criteria for IE and who self-reported IDU in the 3 months before admission were identified. The subset of PWID who developed rIE, defined as another episode of IE at least 10 weeks after diagnosis of the first episode, was then reviewed.ResultsOf the 87 PWID who survived their first episode of IE, 22 (25.3%) experienced rIE and 77.3% had rIE within a year of the first episode. All patients who experienced rIE resumed IDU between episodes of IE. Of the patients with rIE, 54.5% had an infection caused by S. aureus and 22.7% required surgical intervention. Mortality at 1 year was 36.3%. Compared with their first IE episode, patients with rIE had fewer S. aureus infections (P = .01). Compared with PWID who experienced single-episode IE, intravenous prescription opioid use (P = .01), surgery (P < .01), tricuspid valve involvement (P = .02), and polymicrobial infection (P = .03) occurred more often during first episodes of IE in individuals who then developed rIE.ConclusionsrIE is common among IDU-related IE and confers a high 1-year mortality rate. The microbiology of rIE is varied, with S. aureus being less frequently isolated. More studies on modification of social and clinical risk factors are needed to prevent rIE.

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“…This problem is particularly highlighted in North Carolina where IDUaIE admissions increased twelvefold from 0.2 to 2.7 per 100,000 persons per year from 2010 to 2015. These findings reflect the marked increased in abuse of opiates and other pain relievers in the United States and other regions [2]. Alarming statistics of this nature call for a better understanding of the relationship between IDU and the development of endocarditis.…”

Section: Introductionmentioning

confidence: 86%

A Systematic Review of the Association between Individual Drugs Injected Intravenously and the Development of Infective Endocarditis

Serhan¹,

Silverman²

2017

J Addict Res Ther

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Issues: Infective endocarditis (IE) is a relatively rare disease that is associated with a significant amount of morbidity and mortality. Injection drug use associated IE is increasing in incidence, warranting a better understanding of how the drug of choice impacts the development of IE. Many studies have drawn connections between certain drugs injected intravenously and the development of IE but none have rigorously evaluated why a particular drug might predispose persons who inject drugs (PWID) to IE. Approach:The PubMed database was thoroughly searched using combinations of various key words. Human studies with 20 cases or more of injection drug use associated IE that reported on the drugs injected were analyzed and included in this review. Key findings:No specific drug convincingly showed a strong association between its intravenous use and the development of IE, with studies having contradictory findings. The array of findings reported in the reviewed studies are more likely to be due to the frequency of use of particular drugs and their availability in the respective regions of study than the actual physiologic or pharmacologic properties of the drug. Implications:One trend that requires further investigation is the recent surge in opioid injection that has been linked to increased IE hospitalizations in several studies. Conclusion:Future research should aim to better understand how the preparation and/or physical properties of specific drugs may play a role in the development of IE.

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Hospitalizations for Endocarditis and Associated Health Care Costs Among Persons with Diagnosed Drug Dependence — North Carolina, 2010–2015

Cited by 138 publications

References 9 publications

Methicillin-Resistant Staphylococcus aureus Prosthetic Valve Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management

Methicillin-Resistant Staphylococcus aureus Prosthetic Valve Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management

Repeat Infective Endocarditis in Persons Who Inject Drugs: “Take Another Little Piece of my Heart”*

A Systematic Review of the Association between Individual Drugs Injected Intravenously and the Development of Infective Endocarditis

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