Correlates of Injection-related Wounds and Skin Infections Amongst Persons Who Inject Drugs and Use a Syringe Service Programme: A Single Center Study

Overview

Journal Int Wound J

Specialties Emergency Medicine
Orthopedics

Date 2021 Feb 15

PMID 33586860

Citations 9

Authors

Brian A Cahn

Tyler S Bartholomew

Hardik P Patel

Irena Pastar

Hansel E Tookes

Hadar Lev-Tov

Affiliations

Soon will be listed here.

Abstract

Risk factors associated with wounds and skin infections amongst persons who inject drugs may have changed in the era of fentanyl and now stimulant coinjection. We assessed the number of injection site wounds and skin infections and associated factors amongst 675 persons who inject drugs in a syringe services programme. Of this sample, 173 participants reported a total of 307 wounds and skin infections. Significant factors associated with increased number of wounds and skin infections were age 30 or older, female gender, ever experiencing homelessness, cocaine injection, and injecting between 5 and 10 years. Wounds and skin infections were common amongst syringe services programme clients and are associated with certain risk factors that may help to design effective interventions. Given the high prevalence of wounds in syringe services programme clients, wound care clinicians can make a significant difference and improve outcomes. We also shed light on correlates of wounds and skin infections in persons who inject drugs in order to spur further research to devise efficacious interventions for this underserved group.

Citing Articles

A hand-washing community-based educational intervention to reduce abscess incidence among people who inject drugs: a cluster randomised controlled clinical trial protocol (the HAWA study protocol).

Balhan L, Aubert M, Lacoux C, Grau N, Levy J, Stefanowski M BMC Public Health. 2024; 24(1):2858.

PMID: 39420312 PMC: 11484296. DOI: 10.1186/s12889-024-20299-x.

Syringe services program staff and participant perspectives on changing drug consumption behaviors in response to xylazine adulteration.

Eger W, Plesons M, Bartholomew T, Bazzi A, Hauschild M, McElrath C Harm Reduct J. 2024; 21(1):162.

PMID: 39210359 PMC: 11363649. DOI: 10.1186/s12954-024-01082-y.

The effect of Montreal's supervised consumption sites on injection-related infections among people who inject drugs: An interrupted time series.

Lim J, Panagiotoglou D PLoS One. 2024; 19(8):e0308482.

PMID: 39190638 PMC: 11349102. DOI: 10.1371/journal.pone.0308482.

Protective or potentially harmful? Altering drug consumption behaviors in response to xylazine adulteration.

Eger W, Plesons M, Bartholomew T, Bazzi A, Hauschild M, McElrath C Res Sq. 2024; .

PMID: 39149447 PMC: 11326414. DOI: 10.21203/rs.3.rs-4810429/v1.

Community-Based Wound Care Programs for Unhoused Individuals.

Goto T, Wang C, Kwiat C, Nguyen C, Saligan L J Epidemiol Glob Health. 2023; 13(4):604-614.

PMID: 37847465 PMC: 10686911. DOI: 10.1007/s44197-023-00157-6.

References

Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008; 42(2):377-81. PMC: 2700030. DOI: 10.1016/j.jbi.2008.08.010. View

Robinowitz N, Smith M, Serio-Chapman C, Chaulk P, Johnson K . Wounds on wheels: implementing a specialized wound clinic within an established syringe exchange program in Baltimore, Maryland. Am J Public Health. 2014; 104(11):2057-9. PMC: 4202967. DOI: 10.2105/AJPH.2014.302111. View

Phillips K, Stein M . Risk practices associated with bacterial infections among injection drug users in Denver, Colorado. Am J Drug Alcohol Abuse. 2010; 36(2):92-7. PMC: 4869685. DOI: 10.3109/00952991003592311. View

Abbasi J . CDC Says More Needle Exchange Programs Needed to Prevent HIV. JAMA. 2017; 317(4):350. DOI: 10.1001/jama.2016.19452. View

Wurcel A, Burke D, Skeer M, Landy D, Heimer R, Wong J . Sex work, injection drug use, and abscesses: Associations in women, but not men. Drug Alcohol Depend. 2018; 185:293-297. PMC: 5991097. DOI: 10.1016/j.drugalcdep.2017.12.028. View

Li Q, Cassese A, Guindani M, Vannucci M . Bayesian negative binomial mixture regression models for the analysis of sequence count and methylation data. Biometrics. 2018; 75(1):183-192. DOI: 10.1111/biom.12962. View

Iyengar S, Kravietz A, Bartholomew T, Forrest D, Tookes H . Baseline differences in characteristics and risk behaviors among people who inject drugs by syringe exchange program modality: an analysis of the Miami IDEA syringe exchange. Harm Reduct J. 2019; 16(1):7. PMC: 6343273. DOI: 10.1186/s12954-019-0280-z. View

. Needle exchange. UN report encourages syringe exchanges to reduce HIV. AIDS Policy Law. 2016; 31(6):1, 4. View

Peak C, Rosen H, Kamali A, Poe A, Shahkarami M, Kimura A . Wound Botulism Outbreak Among Persons Who Use Black Tar Heroin - San Diego County, California, 2017-2018. MMWR Morb Mortal Wkly Rep. 2019; 67(5152):1415-1418. PMC: 6334826. DOI: 10.15585/mmwr.mm675152a3. View

10.

Platt L, Minozzi S, Reed J, Vickerman P, Hagan H, French C . Needle syringe programmes and opioid substitution therapy for preventing hepatitis C transmission in people who inject drugs. Cochrane Database Syst Rev. 2017; 9:CD012021. PMC: 5621373. DOI: 10.1002/14651858.CD012021.pub2. View

11.

Bartholomew T, Tookes H, Bullock C, Onugha J, Forrest D, Feaster D . Examining risk behavior and syringe coverage among people who inject drugs accessing a syringe services program: A latent class analysis. Int J Drug Policy. 2020; 78:102716. PMC: 7302981. DOI: 10.1016/j.drugpo.2020.102716. View

12.

Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P . Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. Lancet Glob Health. 2017; 5(12):e1192-e1207. PMC: 5683738. DOI: 10.1016/S2214-109X(17)30375-3. View

13.

OKeefe D, Aitken C, Higgs P, Dietze P . Concordance between self-reported and actual hepatitis C virus infection status in a cohort of people who inject drugs. Drug Alcohol Rev. 2012; 32(2):208-10. DOI: 10.1111/j.1465-3362.2012.00502.x. View

14.

Kral A, Davidson P . Addressing the Nation's Opioid Epidemic: Lessons from an Unsanctioned Supervised Injection Site in the U.S. Am J Prev Med. 2017; 53(6):919-922. DOI: 10.1016/j.amepre.2017.06.010. View

15.

Biancarelli D, Biello K, Childs E, Drainoni M, Salhaney P, Edeza A . Strategies used by people who inject drugs to avoid stigma in healthcare settings. Drug Alcohol Depend. 2019; 198:80-86. PMC: 6521691. DOI: 10.1016/j.drugalcdep.2019.01.037. View

16.

Chen J, Fullerton K, Flynn N . Necrotizing fasciitis associated with injection drug use. Clin Infect Dis. 2001; 33(1):6-15. DOI: 10.1086/320874. View

17.

Roose R, Hayashi A, Cunningham C . Self-management of injection-related wounds among injecting drug users. J Addict Dis. 2009; 28(1):74-80. PMC: 2695510. DOI: 10.1080/10550880802545200. View

18.

Dahlman D, Berge J, Bjorkman P, Nilsson A, Hakansson A . Both localized and systemic bacterial infections are predicted by injection drug use: A prospective follow-up study in Swedish criminal justice clients. PLoS One. 2018; 13(5):e0196944. PMC: 5979029. DOI: 10.1371/journal.pone.0196944. View

19.

Larney S, Peacock A, Mathers B, Hickman M, Degenhardt L . A systematic review of injecting-related injury and disease among people who inject drugs. Drug Alcohol Depend. 2016; 171:39-49. DOI: 10.1016/j.drugalcdep.2016.11.029. View

20.

Bartholomew T, Onugha J, Bullock C, Scaramutti C, Patel H, Forrest D . Baseline prevalence and correlates of HIV and HCV infection among people who inject drugs accessing a syringe services program; Miami, FL. Harm Reduct J. 2020; 17(1):40. PMC: 7288490. DOI: 10.1186/s12954-020-00385-0. View