Transmission Of Tuberculosis Among illicit drug use Linkages (TOTAL): A cross-sectional observational study protocol using respondent driven sampling

Carney, Tara; Rooney, Jennifer; Niemand, Nandi; Myers, Bronwyn; Theron, Danie; Wood, Robin; White, Laura F.; Meade, Christina S.; Chegou, Novel N.; Ragan, Elizabeth J.; Walzl, Gerhard; Horsburgh, R; Warren, Robin M.; Jacobson, Karen R

doi:10.1371/journal.pone.0262440

Cited by 4 publications

(2 citation statements)

References 58 publications

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“…CAP is also seen among drug abusers. Intravenous drug use has additionally been related to greater severity of CAP, which might be evident by the development of empyema, complicated parapneumonic effusion, or the need for mechanical ventilation [ 31 ]. The most common bacterial infective organisms in IVDUs are Staphylococcus aureus and Streptococcus pneumoniae [ 29 ].…”

Section: Reviewmentioning

confidence: 99%

Assessment of Bacterial Infections and Antibiotic Regimens in Intravenous Drug Users

Rehman,

Arif,

Ushakumari

et al. 2023

Cureus

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Bacterial infections in people who inject drugs (PWID) are a significant cause of hospitalizations and increased morbidity in this group. In this review, we evaluated bacterial trends in the most common infections and appropriate empiric antibiotic coverage. Articles from PubMed and Google Scholar were curated in a Google document with shared access. Discussion and development of the paper were achieved over Zoom meetings. The common infections in PWID were skin and soft tissue infections (SSTIs), infective endocarditis, septic arthritis, osteomyelitis, and bloodstream infections (BSIs). The presence of comorbidities increased susceptibility to bacterial infections. Staphylococcus aureus was the predominant species in all the infections and included methicillin-resistant S. aureus (MRSA) and methicillin-sensitive S. aureus (MSSA). The current standard of antibiotic use for Staphylococcus species was found to be sufficient. The gram-negative bacillus Serratia marcescens was prevalent in PWID as a causative agent of septic arthritis, osteomyelitis, and infective endocarditis. Its treatment required a combination of β-lactam and either a fluoroquinolone or an aminoglycoside for a prolonged duration. Streptococci were commonly implicated in SSTIs and BSIs. The appropriate response was seen with β-lactam antibiotics. In PWID, Enterococcus and Pseudomonas were implicated in infective endocarditis of native and prosthetic valves. The former being difficult to treat, a new strategy of using dual β-lactam antibiotics was found to be supported by clinical data. Anti-pseudomonal antibiotics can be avoided in other infections seen in this group, as their prevalence was low. PWID, especially those with comorbidities, have an increased risk of acquiring infections with difficult-to-treat microbes. Therefore, empiric antibiotic treatment should be relevant to the infection, for which bacterial trends and antibiotic susceptibility must be reassessed periodically.

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Section: Reviewmentioning

confidence: 99%

Assessment of Bacterial Infections and Antibiotic Regimens in Intravenous Drug Users

Rehman,

Arif,

Ushakumari

et al. 2023

Cureus

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“…Illicit drug use is not uncommon in persons with TB. 18 In South Africa, methaqualone (locally known as Mandrax) and methamphetamine (locally known as tik) are two of the most commonly used illicit drugs. 19 Further complicating the picture is the previously reported association between low body weight and low TB drug exposures in patients on the standard first-line regimen, 20–22 which is designed to administer the same mg/kg dose regardless of body size, disregarding allometry.…”

Section: Introductionmentioning

confidence: 99%

The impact of alcohol and illicit substance use on the pharmacokinetics of first-line TB drugs

Wijk,

Gausi,

Malatesta

et al. 2024

Journal of Antimicrobial Chemotherapy

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Background In South Africa, an estimated 11% of the population have high alcohol use, a major risk factor for TB. Alcohol and other substance use are also associated with poor treatment response, with a potential mechanism being altered TB drug pharmacokinetics. Objectives To investigate the impact of alcohol and illicit substance use on the pharmacokinetics of first-line TB drugs in participants with pulmonary TB. Methods We prospectively enrolled participants ≥15 years old, without HIV, and initiating drug-susceptible TB treatment in Worcester, South Africa. Alcohol use was measured via self-report and blood biomarkers. Other illicit substances were captured through a urine drug test. Plasma samples were drawn 1 month into treatment pre-dose, and 1.5, 3, 5 and 8 h post-dose. Non-linear mixed-effects modelling was used to describe the pharmacokinetics of rifampicin, isoniazid, pyrazinamide and ethambutol. Alcohol and drug use were tested as covariates. Results The study included 104 participants, of whom 70% were male, with a median age of 37 years (IQR 27–48). Alcohol use was high, with 42% and 28% of participants having moderate and high alcohol use, respectively. Rifampicin and isoniazid had slightly lower pharmacokinetics compared with previous reports, whereas pyrazinamide and ethambutol were consistent. No significant alcohol use effect was detected, other than 13% higher ethambutol clearance in participants with high alcohol use. Methaqualone use reduced rifampicin bioavailability by 19%. Conclusion No clinically relevant effect of alcohol use was observed on the pharmacokinetics of first-line TB drugs, suggesting that poor treatment outcome is unlikely due to pharmacokinetic alterations. That methaqualone reduced rifampicin means dose adjustment may be beneficial.

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Inferring bivariate associations with continuous data from studies using respondent-driven sampling

Malatesta,

Jacobson,

Carney

et al. 2024

Journal of the Royal Statistical Society Series C: Applied Statistics

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Respondent-driven sampling (RDS) is a link-tracing sampling design that was developed to sample from hidden populations. Although associations between variables are of great interest in epidemiological research, there has been little statistical work on inference on relationships between variables collected through RDS. The link-tracing design, combined with homophily, the tendency for people to connect to others with whom they share characteristics, induces similarity between linked individuals. This dependence inflates the Type 1 error of conventional statistical methods (e.g. t-tests, regression, etc.). A semiparametric randomization test for bivariate association was developed to test for association between two categorical variables. We directly extend this work and propose a semiparametric randomization test for relationships between two variables, when one or both are continuous. We apply our method to variables that are important for understanding tuberculosis epidemiology among people who smoke illicit drugs in Worcester, South Africa.

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Transmission Of Tuberculosis Among illicit drug use Linkages (TOTAL): A cross-sectional observational study protocol using respondent driven sampling

Cited by 4 publications

References 58 publications

Assessment of Bacterial Infections and Antibiotic Regimens in Intravenous Drug Users

Assessment of Bacterial Infections and Antibiotic Regimens in Intravenous Drug Users

The impact of alcohol and illicit substance use on the pharmacokinetics of first-line TB drugs

Inferring bivariate associations with continuous data from studies using respondent-driven sampling

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