Both localized and systemic bacterial infections are predicted by injection drug use: A prospective follow-up study in Swedish criminal justice clients

• DOI: 10.1371/journal.pone.0196944
• Publication Date: 2018-05-31T13:55:42Z
• Authors: Disa Dahlman; Jonas Berge; Per Björkman; Anna C. Nilsson; Anders Håkansson
• Keywords: Adult; Male; Sweden; Science; Incidence; Q; R; Bacterial Infections; 16. Peace & justice; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Risk Factors; Prisons; Medicine; Humans; Female; Prospective Studies; Substance Abuse, Intravenous; 0305 other medical science; Research Article; Follow-Up Studies; Proportional Hazards Models

Background Both skin and soft tissue infections (SSTI) systemic bacterial are common in people who inject drugs (PWID), but data on incidence risk factors lacking. We compared registered diagnoses for such Swedish criminal justice clients with regard to injecting drug use. Methods Baseline interview from the Prison Probation Service use PWID non-PWID problematic alcohol were linked follow-up national registers hospital and/or death. Associations between later diagnosis of SSTI infection (septicemia or heart, bone/joints central nervous system) analyzed by Cox regression. Results Incidence rates was 28.3 per 1,000 person-years (n = 2,444) 10.0 735). 9.1 2.7 non-PWID. Injection associated a significantly increased infections, main heroin (SSTI: Hazard ratio [HR] 2.45; infection: HR 2.75), amphetamine 1.60; 2.19), polysubstance 1.92; 2.01). In relation injection use, mainly using had higher SSTI. Conclusions predicted both infection, particularly high heroin. The results imply need attention among PWID, terms clinical management, prevention research.