Injection site bacterial infections among people who inject psychoactive drugs: 2015-2016
Author(s): ,
Rachel Glass
Affiliations:
Public Health England
,
Claire Tanner
Affiliations:
Public Health England
,
Vivian Hope
Affiliations:
Public Health England
,
Katy Sinka
Affiliations:
Public Health England
Ellen Heinsbroek
Affiliations:
Public Health Engladn
PHE ePoster Library. Edmundson C. Mar 20, 2018; 205891; 12510
Claire Edmundson
Claire Edmundson
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Abstract
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Abstract BackgroundPeople who inject drugs (PWID) are at risk of injection related skin and soft tissue infections (SSTI). Often due to poor hygiene and unsafe injecting practises, these infections can result in severe illness and place substantive pressure on healthcare services.MethodsData from a national unlinked-anonymous survey in England, Wales and Northern Ireland from 2015-2016 were examined. Analysis included those injecting in the last month. Injecting and environmental risk factors associated with reporting SSTI symptoms (an abscess, sore or open wound) at an injection site were compared by gender.Results Approximately one third of PWID surveyed reported bacterial infections at an injection site (36% [889/2,459]), which was higher among females than males (42% vs 34%, p=0.001). Factors associated with SSTI symptoms among men (n=1,774) were: injecting heroin (AOR 1.77, p=0.013), injecting heroin and crack (AOR 2.00, p=0.002), injecting ≥3 times a day (AOR 1.25, p=0.031), sharing injecting equipment (AOR 1.39, p=0.002), overdosing in the past year (AOR 1.44, p=0.004) and older age (45+ vs <30 years; AOR 1.51, p=0.017). Factors associated with SSTI symptoms among women (n=551) were: homelessness (AOR 2.28, p=0.001), injecting mephedrone (AOR 3.58, p=0.044), injecting daily (AOR 2.11, p<0.001), sharing injecting equipment (AOR 1.70, p=0.005) and transactional sex (AOR 2.19, p=0.001). There was no significant difference in reporting SSTI symptoms by blood-borne viral status (current HIV, ever hepatitis C and ever hepatitis B infection) after adjusting for age and homelessness.ConclusionPWID are at significant risk of bacterial infections in the UK, with reporting of injection related infections being more common among women. Interventions to encourage prompt diagnoses and treatment should be responsive to different injecting and environmental risk factors for men and women. Interventions to improve the accessibility of wound care, sterile injecting equipment and opioid substitution therapy to PWID are indicated. Funding PHE funded
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