PMID- 34028966
OWN - NLM
STAT- MEDLINE
DCOM- 20221024
LR  - 20221205
IS  - 1445-5994 (Electronic)
IS  - 1444-0903 (Linking)
VI  - 52
IP  - 10
DP  - 2022 Oct
TI  - Clinical and financial burden of spinal infections in people who inject drugs.
PG  - 1741-1748
LID - 10.1111/imj.15397 [doi]
AB  - BACKGROUND: People who inject drugs (PWID) are known to be at increased risk of 
      infectious diseases including bacterial and blood-borne viral infections. 
      However, there is limited literature surrounding the burden of spinal infections 
      as a complication of injecting drug use (IDU). AIMS: To quantify the clinical and 
      financial burden of IDU-related spinal infections. METHODS: Retrospective chart 
      review of adult PWID with spinal infections requiring hospital admission to a 
      tertiary health service in Melbourne, Australia between 2011 and 2019. RESULTS: 
      Fifty-seven PWID with 63 episodes of spinal infections were identified with a 
      median hospital stay of 47 days (interquartile range (IQR) 16; range 4-243 days). 
      One-third of episodes required neurosurgical intervention and 11 (17%) episodes 
      required intensive care unit admission (range 2-17 days). Staphylococcus aureus 
      was the most common causative pathogen, present in three-quarters of all episodes 
      (n = 47). The median duration of antibiotic regime was 59 days (IQR 42) and 
      longer courses were associated with known bacteraemia (P = 0.048), polymicrobial 
      infections (P = 0.001) and active IDU (P = 0.066). Predictors of surgery include 
      neurological symptoms at presentation (relative risk (RR) 2.6; P = 0.010), 
      inactive IDU status (RR 3.0; P = 0.002), a diagnosis of epidural abscess (RR 4.1; 
      P = 0.001) and spinal abscess (RR infinity; P < 0.001). Completion of planned 
      antimicrobial therapy was reported in 51 (82%) episodes. Average expenditure per 
      episode was  A$61 577. CONCLUSIONS: Spinal infections in PWID are an 
      underreported serious medical complication of IDU. Although mortality is low, 
      there is significant morbidity with prolonged admissions, large antimicrobial 
      requirements and surgical interventions generating a substantial cost to the 
      health system.
CI  - (c) 2021 Royal Australasian College of Physicians.
FAU - Ananda, Roshan A
AU  - Ananda RA
AUID- ORCID: 0000-0001-7661-8067
AD  - Monash Infectious Disease, Monash Health, Melbourne, Victoria, Australia.
AD  - School of Clinical Sciences, Monash Health, Monash University, Melbourne, 
      Victoria, Australia.
FAU - Attwood, Lucy O
AU  - Attwood LO
AUID- ORCID: 0000-0003-0447-7917
AD  - Monash Infectious Disease, Monash Health, Melbourne, Victoria, Australia.
FAU - Lancaster, Reece
AU  - Lancaster R
AD  - Monash Addiction Medicine, Monash Health, Melbourne, Victoria, Australia.
FAU - Jacka, David
AU  - Jacka D
AD  - Monash Addiction Medicine, Monash Health, Melbourne, Victoria, Australia.
FAU - Jhoomun, Tanya
AU  - Jhoomun T
AD  - Monash Neurosurgery, Monash Health, Melbourne, Victoria, Australia.
FAU - Danks, Andrew
AU  - Danks A
AD  - Monash Neurosurgery, Monash Health, Melbourne, Victoria, Australia.
FAU - Woolley, Ian
AU  - Woolley I
AUID- ORCID: 0000-0003-2928-1291
AD  - Monash Infectious Disease, Monash Health, Melbourne, Victoria, Australia.
AD  - School of Clinical Sciences, Monash Health, Monash University, Melbourne, 
      Victoria, Australia.
LA  - eng
PT  - Journal Article
DEP - 20220603
PL  - Australia
TA  - Intern Med J
JT  - Internal medicine journal
JID - 101092952
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Substance Abuse, Intravenous/complications/epidemiology
MH  - *Drug Users
MH  - Retrospective Studies
MH  - Financial Stress
MH  - Anti-Bacterial Agents
OTO - NOTNLM
OT  - abscess
OT  - epidural abscess
OT  - infection
OT  - intravenous
OT  - spine
OT  - substance abuse
EDAT- 2021/05/25 06:00
MHDA- 2022/10/25 06:00
CRDT- 2021/05/24 12:48
PHST- 2021/04/08 00:00 [revised]
PHST- 2021/02/04 00:00 [received]
PHST- 2021/05/18 00:00 [accepted]
PHST- 2021/05/25 06:00 [pubmed]
PHST- 2022/10/25 06:00 [medline]
PHST- 2021/05/24 12:48 [entrez]
AID - 10.1111/imj.15397 [doi]
PST - ppublish
SO  - Intern Med J. 2022 Oct;52(10):1741-1748. doi: 10.1111/imj.15397. Epub 2022 Jun 3.