Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-14T04:35:50.915Z Has data issue: false hasContentIssue false
  • English
  • Français

Increased Incidence of Infections in Intravenous Drug Users

Published online by Cambridge University Press:  21 June 2016

Charles R. Horsburgh Jr ,
Judith R. Anderson  and
Edward J. Boyko
Charles R. Horsburgh Jr
Affiliation:
Divisions of General Internal Medicine and Infectious Diseases, Department of Medicine, University of Colorado Health Sciences Center, and Denver General Hospital. Denver, Colorado
Judith R. Anderson
Affiliation:
Divisions of General Internal Medicine and Infectious Diseases, Department of Medicine, University of Colorado Health Sciences Center, and Denver General Hospital. Denver, Colorado
Edward J. Boyko
Affiliation:
Divisions of General Internal Medicine and Infectious Diseases, Department of Medicine, University of Colorado Health Sciences Center, and Denver General Hospital. Denver, Colorado
Get access Rights & Permissions [Opens in a new window]

Abstract

To ascertain the incidence of infections in intravenous users of illicit drugs, we performed a retrospective study of 270 intravenous drug users (IVDUs) and 562 controls who did not use drugs over a seven-year period from 1978-1985. IVDUs had an increased overall incidence of infections (P <0.00l) compared to controls, which was explained to a large degree by an increased incidence of hepatitis. Endocarditis and disseminated gonococcal infection were seen with increased frequency in IVDUs (P <0.05), but abscess and cellulitis were not. Neither acquired immunodeficiency syndrome (AIDS), tuberculosis, Pneumocystis pneumonia, nor disseminated viral or fungal infection were seen in IVDUs or controls. Heroin users, but not other IVDUs, had an increased incidence of infections not thought to be associated with needle use, suggesting impaired immunity. This study demonstrates that IVDUs have an increased incidence of infection compared to control subjects, but the kinds of infections have changed substantially over the past two decades. The presence of opportunistic pathogens in these patients should suggest concurrent infection with human immunodeficiency virus (HIV).

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 5 , May 1989 , pp. 211 - 215
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Hussey, HH, Katz, S Infections resulting from narcotic addiction. Report of 102 cases. Am J Med. 1931;9:186–193.CrossRefGoogle Scholar
2. Louria, DB. Hensle, T, Rose, J: The major medical complications of heroin addiction. Ann Intern Med. 1967;67:t–22.Google Scholar
3. Cherubin, CE: The medical sequelae of narcotic addiction. Ann Intern Med tY67;67:23–33.CrossRefGoogle Scholar
4. Sapira, JD: The narcotic addict as a medical patient. Am J Mud. 1968;45:555–588.CrossRefGoogle ScholarPubMed
5. Reisberg, BE: Infective endocarditis in the narcotic addict. Prog Cardiovase Dis. 1979;22:193–204.CrossRefGoogle ScholarPubMed
6. Banks, T. Fletcher, R, Ali, N: Infective endocarditis in heroin addicts. Am J Med. 1973;55:444–451.CrossRefGoogle ScholarPubMed
7. Bick, RL, Anhalt, JE: Malaria in drug addicts. JAMA. 1971;216:1036.CrossRefGoogle ScholarPubMed
8. Chandrasekar, PH, Narula At': Bone and joint infections in intravenous drug abusers. Rev Infect Dis. 1986;8:904–911.Google Scholar
9. Holzman, KS. Bishko, F: Osteomyelitis in heroin addicts. Ann Intern Med. 1971;75:693–696.Google Scholar
10. Kozel, NJ, Adams, EH: Epidemiology of drug abuse: An overview. Science. 1986;234:970–974.Google Scholar
11. Colorado State Epidemiology Work Group Report, October 24, 1986. Denver, Alcohol and Drug Abuse Division. Colorado Department of Health, 1987.Google Scholar
12. Segel, S Nonparametric Statistics for the Behavioral Sciences. New York, McGraw-Hill, 1956, pp 184–193.Google Scholar
13. Snedecor, GW, Cochran, WG: Statistical Methods, ed 7. Ames Iowa, Iowa sate University Press. 1980, pp 64-68, 121–124.Google Scholar
14. Rothman, KJ, Boice, JD Jr: Epidemiologic Analysis with a Programmable Calculator, Boston, Epidemiology Resources Inc, 1982.Google Scholar
15. Kleinbaum, DG, Kupper, LL, Morgenstern, H: Epidemiologir Research. Belmont, Calif. Lifetime Learning Publications. 1982, pp 284–292.Google Scholar
16. Kozak, LJ, Moien, M: Detailed Diagnosis and Surgical Procedures for Patients Discharged from Short-Stay Hospitals, 1983. Vital and Health Statistics. Series 13. No. 82, US Dept of Health and Human Services publication No. (PHS) 85-1743. Government Printing Office, tYX5.Google Scholar
17. MacGregor, UK: Alcohol and immune defense. JAMA. 1986;256:755–759.Google Scholar
18. Adams, AG, Jordan, C: Infections in the alcoholic. Med Clin North Am. 1984;68;179–200.Google Scholar
19. Simbcrkoff, MS: Infections in parenteral narcotic and drug abusers, in Grieco, MH (ed): Infection in the Abnormal Host. New York, Yorke Medical Books, 1980, pp 508–520.Google Scholar
20. Felton, CP: Pulmonary infections in the addict, in Richter, RW (ed): Medical Aspects oof Drug Abuse. Hagerstown. Md, Harper and Row Publishers Inc. 1975, pp 232–242.Google Scholar
21. Desjarlais, DC. Friedman, SR: HIV infection among intravenous drug users: Epidemiology and risk reduction. Aids. 1987;1:67–76.Google Scholar
22. Dupont, A Drouhet, E: Cutaneous ocular and osteoarticulin candidiasis tri heroin addicts: New clinical and therapeutic aspects in 38 patients. J Infect Dis. 1985;142:577–591.CrossRefGoogle Scholar
23. Podzamczer, D, Gadiol, F: Systemic candidiasis in heroin abusers. J Infect Dis. 1986;153:1182–1183.CrossRefGoogle ScholarPubMed
24. Chambers, HF, Morris, DL Tauber, MG, et al: Cocaine use and the risk for endocarditis in intravenous drug users. Ann Intern Med. 1987;106:833–836.CrossRefGoogle ScholarPubMed
25. Heathcote, J. Taylor, KB: Immunity and nutrition in heroin addicts. Drug Alcohol Depend. 1981;8:245–255.Google Scholar
26. Brown, SM, Stimmel, B, Taub, RN, et al: Immunologic dysfunction in heroin addicts. Arch Intern Med. 1974;134:1001–1006.Google Scholar
27. Wybran, J, Appleboom, I, Famaev, F, et al: Suggestive evidence for receptors for morphine and methionine-enkephalin on normal human blood lymphocytes. J Immunol. 1979;123:1068–1070.Google Scholar
28. Donohoe, KM. Nicholson, JKA. Maddon, JJ, et al: Coordinate and independent effects of heroin, cocaine, and alcohol abuse on T-cell rosette formation and antigenic marker expression. Clin Immunol Immunopathol. 1986;41:254–261.Google Scholar