Microbial Epidemiology of Infectious Endocarditis in the Intravenous Drug Abuse Population: A Retrospective Study

Abstract

Introduction The microbial epidemiology differs between infective endocarditis (IE) patients with and without a history of injection drug use. We set out to determine the prevalence and microbial epidemiology of infective endocarditis in our region, the Southeastern USA, to determine if any changes need to be made in empiric antimicrobial treatment. Methods The electronic medical record was reviewed for patients with IE between January 2013 and July 2017, which revealed 299 cases. The cases were then sorted between patients with and without a history of injection drug use. The growth of their initial set of blood cultures and side of cardiac involvement were then recorded. Statistical analyses were run on the data sets. Results There were statistically significant effects associated with both methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas species infections occurring more often in individuals with active injection drug use, while streptococcus and enterococcus infections were more likely to occur in the population of individuals who do not inject drugs. Conclusion In IE patients who use or are suspected of injection drug use, first-line broad-spectrum antibiotics with excellent MRSA and Pseudomonas coverage are essential.

Comparing Echocardiographic Modalities in Native-Valve Infective Endocarditis Due to Methicillin-Resistant Staphylococcus Aureus in People Who Inject Drugs

“…With the ongoing opioid epidemic and increasing prevalence of injection drug use, the risks of MRSA bacteremia and IE are on the rise [ 11 ]. This study found that obtaining a TEE routinely after a TTE might not be cost-effective in this patient population of PWID with proven native-valve MRSA IE.…”

Etiological Structure of Infective Endocarditis in Certain Categories of Patients (Literature Review)

“…Подобно ИЭ в общей популяции, S. aureus является микроорганизмом, наиболее часто вызывающим ИЭ у ПИН (до 77,2 % случаев ИЭ у потребителей наркотиков против 39,6 % среди пациентов общей популяции) [8,21,22]. Это связано с более высоким уровнем колонизации кожи S. aureus (вероятно, из-за частого нарушения её целостности) у ПИН по сравнению с лицами, использующими наркотики только перорально.…”

“…Нарушение кожного барьера иглой обеспечивает прямое попадание микроорганизмов в кровоток. В работах, посвященных анализу заболевания у ПИН, опубликованных в последние годы, прослеживается преобладание метициллин-чувствительного штамма S. aureus над метициллин-резистентным [18,[21][22][23]. W. Lorson et al (2019) подчеркивают этиологическое значение метициллин-резистентных штаммов S. aureus и Pseudomonas в развитии ИЭ у ПИН и необходимость применения антибиотиков с активностью в отношении этих возбудителей [22].…”

“…Частота выявления представителей группы стрептококков (группа Viridans, энтерококки, другие стрептококки) в проанализированных работах колебалась от 2 до 20 % (Рис. 1) [18,[21][22][23][24].…”

Evaluating new paralysis, mortality, and readmission among subgroups of patients with spinal epidural abscess: A latent class analysis

“…Future research with SEA patients with IVDU is needed to identify how to best support these patients during first and subsequent readmissions, and to better understand why these patients are at higher risk of readmission. Finally, there may be clinically important differences in microbiological etiology of SEA between these two groups, including differences in the incidence of Pseudomonas infections, which could inform empiric antibiotic choice [1,25].…”