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167. Deep Space Infections in Injection Drug Users (IDU)
BACKGROUND: The opioid epidemic in the US has increased attention to infectious complications of injection drug use (IDU). The goal of our study was to ascertain the impact of these infections on the health of our community and institutional burden considering that our institution does not discharge...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809253/ http://dx.doi.org/10.1093/ofid/ofz360.242 |
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author | Bacon, Alfred Emmanuel Claudine, Jurkovitz Horton, Terry Caplan, Richard Fawcett, Mitchell Dal Nogare, Ryan Saunders, Jessica McGraw, Patty |
author_facet | Bacon, Alfred Emmanuel Claudine, Jurkovitz Horton, Terry Caplan, Richard Fawcett, Mitchell Dal Nogare, Ryan Saunders, Jessica McGraw, Patty |
author_sort | Bacon, Alfred Emmanuel |
collection | PubMed |
description | BACKGROUND: The opioid epidemic in the US has increased attention to infectious complications of injection drug use (IDU). The goal of our study was to ascertain the impact of these infections on the health of our community and institutional burden considering that our institution does not discharge patients with IDU for outpatient IV antibiotic treatments due to lack of safe environment and compliance concerns. METHODS: This retrospective study reviewed IDU-associated deep space infections in an 1100 -bed medical center from 2010 through 2014. Pathogens, site of infection, mortality rates and, length of stay (LOS), 3- month readmission (inpatient + observation), leaving against medical advice (AMA) rates for those alive at discharge, were evaluated. ICD-9/10 coding identified admissions related to opioid use and deep infections (endocarditis, diskitis/osteomyelitis, sepsis/bacteremia, empyema). Only the most severe infection was counted for each patient. Charts were reviewed to determine whether IDU was associated with the entree infections. RESULTS: A total of 505 patients met criteria for deep space infections associated with IDU over 5 years. Of those, 305 (60%) were male, 146 (29%) black, 335 (66%) white, 271 (54%) were on Medicaid, 246 (49%) had sepsis/bacteremia, 67 (13%) had endocarditis,143 (28%) discitis/osteomyelitis, 22 (4%) empyema and 27 (5%) other. Mean age was 46 ± 12 years. LOS varied by disease state. The overall median was 10 days, from 8 days for bacteremia/sepsis up to 27 for endocarditis. There were 43 (9%) hospital deaths; 30 (6%) patients left AMA and 209 (45%) patients were readmitted within 3 months. CONCLUSION: Deep space infections in IDU patients result in long LOS, high mortality and high rates of readmissions and departures AMA. Improved algorithms for management that include psychosocial models and incorporate cost-effective and safe antibiotic administration need to be developed. DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6809253 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-68092532019-10-28 167. Deep Space Infections in Injection Drug Users (IDU) Bacon, Alfred Emmanuel Claudine, Jurkovitz Horton, Terry Caplan, Richard Fawcett, Mitchell Dal Nogare, Ryan Saunders, Jessica McGraw, Patty Open Forum Infect Dis Abstracts BACKGROUND: The opioid epidemic in the US has increased attention to infectious complications of injection drug use (IDU). The goal of our study was to ascertain the impact of these infections on the health of our community and institutional burden considering that our institution does not discharge patients with IDU for outpatient IV antibiotic treatments due to lack of safe environment and compliance concerns. METHODS: This retrospective study reviewed IDU-associated deep space infections in an 1100 -bed medical center from 2010 through 2014. Pathogens, site of infection, mortality rates and, length of stay (LOS), 3- month readmission (inpatient + observation), leaving against medical advice (AMA) rates for those alive at discharge, were evaluated. ICD-9/10 coding identified admissions related to opioid use and deep infections (endocarditis, diskitis/osteomyelitis, sepsis/bacteremia, empyema). Only the most severe infection was counted for each patient. Charts were reviewed to determine whether IDU was associated with the entree infections. RESULTS: A total of 505 patients met criteria for deep space infections associated with IDU over 5 years. Of those, 305 (60%) were male, 146 (29%) black, 335 (66%) white, 271 (54%) were on Medicaid, 246 (49%) had sepsis/bacteremia, 67 (13%) had endocarditis,143 (28%) discitis/osteomyelitis, 22 (4%) empyema and 27 (5%) other. Mean age was 46 ± 12 years. LOS varied by disease state. The overall median was 10 days, from 8 days for bacteremia/sepsis up to 27 for endocarditis. There were 43 (9%) hospital deaths; 30 (6%) patients left AMA and 209 (45%) patients were readmitted within 3 months. CONCLUSION: Deep space infections in IDU patients result in long LOS, high mortality and high rates of readmissions and departures AMA. Improved algorithms for management that include psychosocial models and incorporate cost-effective and safe antibiotic administration need to be developed. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6809253/ http://dx.doi.org/10.1093/ofid/ofz360.242 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Bacon, Alfred Emmanuel Claudine, Jurkovitz Horton, Terry Caplan, Richard Fawcett, Mitchell Dal Nogare, Ryan Saunders, Jessica McGraw, Patty 167. Deep Space Infections in Injection Drug Users (IDU) |
title | 167. Deep Space Infections in Injection Drug Users (IDU) |
title_full | 167. Deep Space Infections in Injection Drug Users (IDU) |
title_fullStr | 167. Deep Space Infections in Injection Drug Users (IDU) |
title_full_unstemmed | 167. Deep Space Infections in Injection Drug Users (IDU) |
title_short | 167. Deep Space Infections in Injection Drug Users (IDU) |
title_sort | 167. deep space infections in injection drug users (idu) |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6809253/ http://dx.doi.org/10.1093/ofid/ofz360.242 |
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