Prevalence and incidence of emergency department presentations and hospital separations with injecting-related infections in a longitudinal cohort of people who inject drugs

Abstract

People who inject drugs are at risk of acute bacterial and fungal injecting-related infections. There is evidence that incidence of hospitalizations for injecting-related infections are increasing in several countries, but little is known at an individual level. We aimed to examine injecting-related infections in a linked longitudinal cohort of people who inject drugs in Melbourne, Australia. A retrospective descriptive analysis was conducted to estimate the prevalence and incidence of injecting-related infections using administrative emergency department and hospital separation datasets linked to the SuperMIX cohort, from 2008 to 2018. Over the study period, 33% (95%CI: 31–36%) of participants presented to emergency department with any injecting-related infections and 27% (95%CI: 25–30%) were admitted to hospital. Of 1,044 emergency department presentations and 740 hospital separations, skin and soft tissue infections were most common, 88% and 76%, respectively. From 2008 to 2018, there was a substantial increase in emergency department presentations and hospital separations with any injecting-related infections, 48 to 135 per 1,000 person-years, and 18 to 102 per 1,000 person-years, respectively. The results emphasize that injecting-related infections are increasing, and that new models of care are needed to help prevent and facilitate early detection of superficial infection to avoid potentially life-threatening severe infections.

The burden of skin and soft tissue, bone and joint infections in an Australian cohort of people who inject drugs

“…A more detailed history and identification of source may have been more likely in PWID with spinal infections or IE. A recent study by Curtis et al describing the prevalence injecting-related infections in greater Melbourne using a prospective observational cohort identified 345 PWID admitted to hospital over a ten-year period between 2008 and 2018 (27% of total emergency presentations) [ 32 ]. Given our study excluded PWID admitted to hospital for less than one day, we believe our study describes the minimum burden of IDU-related SSTI in the South-Eastern Victorian, Monash Health catchment.…”

Community-Based Services for Hospitalized Patients With Serious Injection-Related Infections in Alabama: A Brief Report

“…Unfortunately, PWID face stigma and barriers to initiating and engaging in prevention services, such as HIV preexposure prophylaxis (PrEP) and behavioral health services [ 8–13 ]. PWID increasingly rely on hospital emergency and inpatient services to treat acute injection-related infection [ 14 ]. For PWID, these hospitalizations are critical touch points to connect patients to much-needed harm reduction resources in their communities postdischarge to decrease risk of infection and rehospitalization [ 15–18 ].…”