scholarly journals Right-Sided Endocarditis due toStaphylococcus lugdunensis: First Reported Case

1998 ◽  
Vol 9 (4) ◽  
pp. 240-242 ◽  
Author(s):  
CL Cooper ◽  
SH Choudhri ◽  
RJ Hoeschen
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Etiological Agent ◽  
Staphylococcus Lugdunensis ◽  
Documented Case

Staphylococcus lugdunensisis a coagulase-negative organism first identified in 1988. It is often incorrectly identified asStaphylococcus aureus,and has been isolated as the etiological agent in over 20 cases of left-sided endocarditis. This report describes the first documented case of right-sided endocarditis caused byS lugdunensis. This experience suggests thatS lugdunensiscan infect native valves in the absence of any predisposing risk factors such as injection drug use.

scholarly journals Risk Factors, Screening and Treatment Challenges in Staphylococcus aureus Native Septic Arthritis

2020 ◽  
Author(s):  
Valerie C Gobao ◽  
Mostafa Alfishawy ◽  
Clair Smith ◽  
Karin E Byers ◽  
Mohamed Yassin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Drug Use ◽  
Septic Arthritis ◽  
Injection Drug Use ◽  
Predictive Value ◽  
Injection Drug ◽  
Opioid Epidemic ◽  
Demographic Shift ◽  
Predictive Values

Abstract Background Staphylococcus aureus is the most common cause of native septic arthritis. Few studies have characterized this disease during the U.S. opioid epidemic. The role of MRSA nasal screening in this disease has not been elucidated. We sought to identify risk factors and outcomes for S. aureus native septic arthritis and to evaluate MRSA screening in this disease. Methods A retrospective cohort study of native septic arthritis patients (2012-2016) was performed. Demographics, risk factors, and outcomes were compared between Staphylococcus aureus and other native septic arthritis infections. Sensitivity, specificity, and predictive values of MRSA screening were assessed. Results 215 cases of native septic arthritis were included. S. aureus was cultured in 64% (138/215). MRSA was cultured in 23% (50/215). S. aureus was associated with injection drug use (OR: 4.33, CI: 1.74 to 10.81, p=0.002) and switching antibiotics (OR: 3.92, CI: 1.01 to 21.38, p=0.032). For every ten-year increase in age, odds of S. aureus decreased (OR: 0.72, CI: 0.60 to 0.87, p=0.001). For one unit increases in CCMI, odds of S. aureus decreased (OR: 0.82 CI: 0.73 to 0.91, p=0.0004). MRSA screening during admission demonstrated sensitivity of 0.59, specificity of 0.96, positive predictive value of 0.85, and negative predictive value of 0.84 for MRSA native septic arthritis. Conclusions The opioid epidemic may be contributing to a demographic shift in native septic arthritis to younger, healthier individuals. S. aureus native septic arthritis has unique risks, including injection drug use. MRSA screening may be useful to rule in MRSA native septic arthritis.

scholarly journals The Cedar Project: risk factors for transition to injection drug use among young, urban Aboriginal people

2011 ◽  
Vol 183 (10) ◽  
pp. 1147-1154 ◽  
Author(s):  
C. L. Miller ◽  
M. E. Pearce ◽  
A. Moniruzzaman ◽  
V. Thomas ◽  
C. W. Christian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Drug Use ◽  
Injection Drug Use ◽  
Aboriginal People ◽  
Injection Drug ◽  
Project Risk

scholarly journals A Vulnerability Assessment for a Future HIV Outbreak Associated With Injection Drug Use in Illinois, 2017–2018

2021 ◽  
Vol 6 ◽  
Author(s):  
Cara Jane Bergo ◽  
Jennifer R. Epstein ◽  
Stacey Hoferka ◽  
Marynia Aniela Kolak ◽  
Mai T. Pho
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Drug Use ◽  
Injection Drug Use ◽  
Negative Binomial ◽  
Cook County ◽  
Injection Drug ◽  
County Level ◽  
Opioid Use ◽  
Zip Code

The current opioid crisis and the increase in injection drug use (IDU) have led to outbreaks of HIV in communities across the country. These outbreaks have prompted country and statewide examination into identifying factors to determine areas at risk of a future HIV outbreak. Based on methodology used in a prior nationwide county-level analysis by the US Centers for Disease Control and Prevention (CDC), we examined Illinois at the ZIP code level (n = 1,383). Combined acute and chronic hepatitis C virus (HCV) infection among persons <40 years of age was used as an outcome proxy measure for IDU. Local and statewide data sources were used to identify variables that are potentially predictive of high risk for HIV/HCV transmission that fell within three main groups: health outcomes, access/resources, and the social/economic/physical environment. A multivariable negative binomial regression was performed with population as an offset. The vulnerability score for each ZIP code was created using the final regression model that consisted of 11 factors, six risk factors, and five protective factors. ZIP codes identified with the highest vulnerability ranking (top 10%) were distributed across the state yet focused in the rural southern region. The most populous county, Cook County, had only one vulnerable ZIP code. This analysis reveals more areas vulnerable to future outbreaks compared to past national analyses and provides more precise indications of vulnerability at the ZIP code level. The ability to assess the risk at sub-county level allows local jurisdictions to more finely tune surveillance and preventive measures and target activities in these high-risk areas. The final model contained a mix of protective and risk factors revealing a heightened level of complexity underlying the relationship between characteristics that impact HCV risk. Following this analysis, Illinois prioritized recommendations to include increasing access to harm reduction services, specifically sterile syringe services, naloxone access, infectious disease screening and increased linkage to care for HCV and opioid use disorder.

scholarly journals Maternal Bacteremia Caused by Staphylococcus Aureus With a Focus on Infective Endocarditis

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Morgan K Morelli ◽  
Michael P Veve ◽  
Mahmoud A Shorman
Keyword(s):  
Staphylococcus Aureus ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Hospital Mortality ◽  
Injection Drug Use ◽  
Pregnant Patient ◽  
Infectious Complications ◽  
Injection Drug ◽  
Secondary Outcome ◽  
Targeted Interventions

Abstract Background Sepsis is an important cause of morbidity and mortality in the pregnant patient. Injection drug use in pregnant populations has led to increased cases of bacteremia and infective endocarditis (IE) due to Staphylococcus aureus. We describe all cases of S. aureus bacteremia and IE among admitted pregnant patients at our hospital over a 6-year period. Methods This was a retrospective review of pregnant patients hospitalized with S. aureus bacteremia between April 2013 and November 2019. Maternal in-hospital mortality and fetal in-hospital mortality were the primary outcomes measured; the secondary outcome was the rate of 6-month maternal readmission. Results Twenty-seven patients were included; 15 (56%) had IE. The median (interquartile range [IQR]) age was 29 (25–33) years; 22 (82%) patients had methicillin-resistant S. aureus. Infection onset occurred at a median (IQR) of 29 (23–34) weeks’ gestation. Twenty-three (85%) mothers reported active injection drug use, and 21 (78%) were hepatitis C seropositive. Fifteen (56%) mothers required intensive care unit (ICU) care. Twenty-two (81%) patients delivered 23 babies; of the remaining 5 mothers, 3 (11%) were lost to follow-up and 2 (7%) terminated pregnancy. Sixteen (73%) babies required neonatal ICU care, and 4/25 (16%) infants/fetuses died during hospitalization. One (4%) mother died during hospitalization, and 7/26 (27%) mothers were readmitted to the hospital within 6 months for infectious complications. Conclusions Injection drug use is a modifiable risk factor for S. aureus bacteremia in pregnancy. Fetal outcomes were poor, and mothers were frequently readmitted secondary to infection. Future targeted interventions are needed to curtail injection drug use in this population.

scholarly journals Septic Arthritis and the Opioid Epidemic: 1465 Cases of Culture-Positive Native Joint Septic Arthritis From 1990–2018

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
John J Ross ◽  
Kevin L Ard ◽  
Narath Carlile
Keyword(s):  
Staphylococcus Aureus ◽  
Drug Use ◽  
Synovial Fluid ◽  
Septic Arthritis ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Facet Joints ◽  
Cell Counts ◽  
Culture Positive ◽  
Fluid Cell

Abstract Background The clinical spectrum of septic arthritis in the era of the opioid crisis is ill-defined. Methods This is a retrospective chart review of 1465 cases of culture-positive native joint septic arthritis at Boston teaching hospitals between 1990 and 2018. Results Between 1990–2008 and 2009–2018, the proportion of septic arthritis cases involving people who inject drugs (PWID) rose from 10.3% to 20% (P < .0000005). Overall, methicillin-sensitive Staphylococcus aureus (MSSA) caused 41.5% of cases, and methicillin-resistant Staphylococcus aureus (MRSA) caused 17.9%. Gram-negative rods caused only 6.2% of cases. Predictors of MRSA septic arthritis included injection drug use (P < .001), bacteremia (P < .001), health care exposure (P < .001), and advancing age (P = .01). Infections with MSSA were more common in PWID (56.3% vs 38.8%; P < .00001), as were infections with MRSA (24% vs 16.8%; P = .01) and Serratia sp. (4% vs 0.4%; P = .002). Septic arthritis in the setting of injection drug use was significantly more likely to involve the sacroiliac, acromioclavicular, and facet joints; 36.8% of patients had initial synovial fluid cell counts of <50 000 cells/mm3. Conclusions Injection drug use has become the most common risk factor for septic arthritis in our patient population. Septic arthritis in PWID is more often caused by MRSA, MSSA, and Serratia sp., and is more prone to involve the sacroiliac, acromioclavicular, sternoclavicular, and facet joints. Synovial fluid cell counts of <50 000 cells/mm3 are common in culture-positive septic arthritis.

scholarly journals Injection Drug Use and Hepatitis C as Risk Factors for Mortality in HIV-Infected Individuals

2015 ◽  
Vol 69 (3) ◽  
pp. 348-354 ◽  
Author(s):  
Margaret T. May ◽  
Amy C. Justice ◽  
Kate Birnie ◽  
Suzanne M. Ingle ◽  
Colette Smit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug

scholarly journals Staphylococcus aureus injection drug use-associated bloodstream infections are propagated by community outbreaks of diverse lineages

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Laura R. Marks ◽  
Juan J. Calix ◽  
John A. Wildenthal ◽  
Meghan A. Wallace ◽  
Sanjam S. Sawhney ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Drug Use ◽  
Injection Drug Use ◽  
Academic Medical Center ◽  
Bloodstream Infections ◽  
Clonal Expansion ◽  
The United States ◽  
Injection Drug ◽  
Comparative Genomic ◽  
Molecular Features

Abstract Background The ongoing injection drug use (IDU) crisis in the United States has been complicated by an emerging epidemic of Staphylococcus aureus IDU-associated bloodstream infections (IDU-BSI). Methods We performed a case-control study comparing S. aureus IDU-BSI and non-IDU BSI cases identified in a large US Midwestern academic medical center between Jan 1, 2016 and Dec 21, 2019. We obtained the whole-genome sequences of 154 S. aureus IDU-BSI and 91 S. aureus non-IDU BSI cases, which were matched with clinical data. We performed phylogenetic and comparative genomic analyses to investigate clonal expansion of lineages and molecular features characteristic of IDU-BSI isolates. Results Here we show that patients with IDU-BSI experience longer durations of bacteremia and have lower medical therapy completion rates. In phylogenetic analyses, 45/154 and 1/91 contemporaneous IDU-BSI and non-IDU BSI staphylococcal isolates, respectively, group into multiple, unique clonal clusters, revealing that pathogen community transmission distinctively spurs IDU-BSI. Lastly, multiple S. aureus lineages deficient in canonical virulence genes are overrepresented among IDU-BSI, which may contribute to the distinguishable clinical presentation of IDU-BSI cases. Conclusions We identify clonal expansion of multiple S. aureus lineages among IDU-BSI isolates, but not non-IDU BSI isolates, in a community with limited access to needle exchange facilities. In the setting of expanding numbers of staphylococcal IDU-BSI cases consideration should be given to treating IDU-associated invasive staphylococcal infections as a communicable disease.

scholarly journals Risk factors associated with infection of blood-borne virus among people who used methamphetamine

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yilin Cai ◽  
Zheng Dai ◽  
Sijin Wen ◽  
Ruchi Bhandari
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
High School Education ◽  
Poverty Index ◽  
Methamphetamine Use ◽  
Factors Associated ◽  
The U.S

Abstract Background The surge of methamphetamine use has been a complicating factor compounding the steeply increasing number of drug overdose deaths in the U.S. Infection from blood-borne viruses including hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV, related to methamphetamine use continue to grow. This study aims to examine the risk factors associated with HBV, HCV and HIV among people who used methamphetamine. Methods People who ever used methamphetamine were identified from five National Health and Nutrition Examination Survey (NHANES) cohorts, 2007 to 2016. The outcome was either positive or negative for blood-borne viruses as identified from laboratory tests. Weighted statistics for the combined ten years of data were calculated by multiplying the weighted variable for laboratory measurements by 0.2. We examined the association of sexual activities (sexual partners, sexual identity), drug use behaviors (poly-drug use, injection drug use, frequency of drug use, age started using methamphetamine), demographics, and socio-economic status with blood-borne viruses using bivariate and multivariable logistic regression models. Results There were 1132 participants representing approximately 11,996,319 persons who ever used methamphetamine in the U.S. Blood-borne viruses’ positive rate was 13.0 per 100,000. Multivariable logistic regression analyses showed significant associations of blood-borne infections with age 40–49 years (vs. age 20–29 years, adjusted odds ratio 4.77, 95% CI 1.11–20.55), age 50–59 years (vs. age 20–29 years, 10.25, 2.40–43.82), living within poverty index 1–1.9 (vs. poverty index > = 2, 2.55; 1.19–5.49), living below the poverty threshold (vs. poverty index > = 2, 2.55; 1.11–5.86), having lower than high school education (vs. equal or higher than high school education, 3.13; 1.51–6.46), sexual identity as other than heterosexual (vs. heterosexual, 5.60; 1.72–18.28), using methamphetamine and heroin and cocaine (vs. using methamphetamine alone, 4.24; 1.06–16.92), injection drug use (vs. no injection drug use, 3.15; 1.61–6.16), and started using methamphetamine at age above 25 (vs. started using methamphetamine at age between 10 and 17, 2.09; 1.01–4.35). Conclusions Among people who use methamphetamine, those who use polysubstance, or who inject substances, are in urgent need for vaccination and interventions to avoid further harm from blood borne infections.

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