Bacterial Infection Hospitalisations Linked to DUA-IE - EMJ

Bacterial Infection Hospitalisations Linked To Drug Use-Associated Infective Endocarditis

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LONG-TERM risk of mortality and hospitalisation is a consequence of bacterial infection in survivors of drug use-associated infective endocarditis (DUA-IE). Serious bacterial infections are a well-established complication in people who inject drugs, including soft tissue, bloodstream, and skin infections.

Researchers conducted a retrospective state-wide cohort study of 1,874 patients who survived DUA-IE hospitalisation in North Carolina, USA from 2017–2020. The cohort included all documented adult patients with DUA-IE from 2016–2020, and those discharged between 2017–2020. The study aimed to understand the long-term health impact of DUA-IE on survivors.

Results revealed that, within the 3-year study period, there was a 38% risk of death or future hospitalisation among the 1,874 patients surviving DUA-IE hospitalisation. This included 16% of patients dying in the 3 years after 90 days of discharge from hospitalisation, as well as 14% for recurrent endocarditis, 14% for soft tissue, 9% for bacteraemia, 5% for bone/joint, and 4% for spinal infections. Researchers found that the leading causes of death after the initial 90 days post-discharge were accidental poisoning due to drug overdose, and the acute effects of endocarditis and other heart disease complications.

The study concluded that greater focus should be placed on research evaluating risk factors in patient outcomes to understand what interventions could prevent future bacterial infection linked to hospitalisation and mortality. Moreover, previous studies have underscored the necessity of comprehensive care for patients treated for drug use-related infections, and emphasised that novel interventions should seek to overcome the legal and social barriers that drug users frequently face.

Figgatt CM et al. Long-term risk of serious infections and mortality among patients surviving drug use–associated infective endocarditis. Clin Infect Dis. 2024; DOI/10.1093/cid/ciae214.

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