scholarly journals Rising rates of injection drug use associated infective endocarditis in Virginia with missed opportunities for addiction treatment referral: a retrospective cohort study

2018 ◽  
Vol 18 (1) ◽  
Author(s):  
Megan E. Gray ◽  
Elizabeth T. Rogawski McQuade ◽  
W. Michael Scheld ◽  
Rebecca A. Dillingham
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Addiction Treatment ◽  
Injection Drug ◽  
Missed Opportunities

scholarly journals Overrepresentation of Injection Drug Use Route of Infection Among Human Immunodeficiency Virus Long-term Nonprogressors: A Nationwide, Retrospective Cohort Study in China, 1989–2016

2019 ◽  
Vol 6 (5) ◽  
Author(s):  
Jing Han ◽  
Zunyou Wu ◽  
Jennifer M McGoogan ◽  
Yurong Mao ◽  
Houlin Tang ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Drug Use ◽  
Injection Drug Use ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Injection Drug ◽  
Route Of Infection ◽  
Immunodeficiency Virus

Abstract Background Why some persons living with human immunodeficiency virus (HIV) (PLWH) progress quickly and others remain “healthy” for a decade or more without treatment remains a fundamental question of HIV pathology. We aimed to assess the epidemiological characteristics of HIV long-term nonprogressors (LTNPs) based on a cohort of PLWH in China observed between 1989 and 2016. Methods We conducted a nationwide, retrospective cohort study among Chinese PLWH with HIV diagnosed before 1 January 2008. Records were extracted from China’s national HIV/AIDS database on 30 June 2016. LTNPs were defined as those with AIDS-free, antiretroviral therapy–naive survival, with CD4 cell counts consistently ≥500/μL for ≥8 years after diagnosis. Prevalence was calculated, characteristics were described, and determinants were assessed by means of logistic regression. Potential sources of bias were also investigated. Results Our cohort included 89 201 participants, of whom 1749 (2.0%) were categorized as LTNPs. The injection drug use (IDU) route of infection was reported by 70.7% of LTNPs, compared with only 37.1% of non-LTNPs. The odds of LTNP status were greater among those infected via IDU (adjusted odds ratio [95% confidence interval], 2.28 [1.94–2.68]) and with HIV diagnosed in settings with large populations of persons who inject drugs (1.75 [1.51–2.02] for detention centers, 1.61 [1.39–1.87] for Yunnan, 1.94 [1.62–2.31] for Guangdong, and 2.90 [2.09–4.02] for Xinjiang). Conclusions Overrepresentation of the IDU route of infection among LTNPs is a surprising finding worthy of further study, and this newly defined cohort may be particularly well suited to exploration of the molecular biological mechanisms underlying HIV long-term nonprogression.

scholarly journals Inconsistent Addiction Treatment for Patients Undergoing Cardiac Surgery for Injection Drug Use-Associated Infective endocarditis

2019 ◽  
Author(s):  
Max Jordan Nguemeni Tiako ◽  
Seong Hong ◽  
Syed Usman Bin Mahmood ◽  
Makoto Mori ◽  
Abeel Mangi ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Addiction Treatment ◽  
Active Drug ◽  
Tertiary Care ◽  
Rehabilitation Program ◽  
Injection Drug ◽  
Drug Rehabilitation ◽  
Significant Difference

AbstractIntroductionCases of injection drug use-related infective endocarditis (IDU-IE) requiring surgery are rising in the setting of the current U.S. opioid epidemic. We thus aimed to determine the nature of addiction interventions in the perioperative period.MethodsThis is a retrospective review of surgical IDU-IE from 2011 to 2016 at a tertiary care center in New Haven, Connecticut. The data collected included substances consumed recreationally, consultations by social work (SW), psychiatry, pharmacotherapy for addiction, and evidence of enrollment in a drug rehabilitation program upon discharge.Among patients with active drug use (ADU), we compared the 24-month survival of those who received at least one form of addiction intervention to that of those who did not.ResultsForty-two patients (75%) had active drug use. Among them, 22 used heroin. Forty-one patients (73.2%) saw SW, 17 (30.4%) saw psychiatry; 14 (25%) saw neither SW nor psychiatry.Twenty-one patients (37.5%) received methadone, 6 (10.7%) received buprenorphine, 1 (0.02%) received naltrexone; 26 (46.4%) did not receive any pharmacotherapy. Fifteen patients (26.8%) attended a drug rehabilitation program, 13 (86.7%) of whom had seen SW and 8 (53%) psychiatry. Among patients with ADU, there was no statistically significant difference in survival between those who received at least one intervention and those who did not (p=0.1 by log rank).ConclusionAddiction interventions are deployed inconsistently for patients with surgical IDU-IE. Untreated substance use disorder and recurrent endocarditis are the leading cause of death in this population. Studying best-practices for perioperative interventions in IDU-IE and establishing protocols are of the upmost importance.

scholarly journals 1022. Rising Rates of Injection Drug Use Associated Infective Endocarditis in Virginia With Missed Opportunities for Injection Drug Use Disorder Treatment Referral: A Retrospective Cohort Study

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S304-S305 ◽  
Author(s):  
Megan Gray ◽  
Elizabeth Rogawski ◽  
Michael W Scheld ◽  
Rebecca Dillingham
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Addiction Treatment ◽  
Medical Center ◽  
Temporal Trends ◽  
Prevalence Ratio ◽  
Interquartile Range ◽  
Injection Drug ◽  
Drug Use Disorder

Abstract Background Injection drug use disorder (IDD) is a growing public health threat in Virginia, although there is limited knowledge of related morbidity. The purpose of this study was to describe the temporal, geographic, and clinical trends and characteristics of infective endocarditis associated with IDD (IDD-IE) and to identify opportunities for better-quality care of people with IDD. Methods We reviewed charts for all admissions coded for both IE and drug use disorders at the University of Virginia Medical Center (UVA) from January 2000 to July 2016. A random sample of 30 admissions coded for IE per year were reviewed to evaluate temporal trends in the proportion of IDD associated IE cases. Results There were a total of 76 patients with IDD-IE during the study period, with a 7-fold increase in cases of IDD-IE from the early 2000s to 2016. The proportion of IE that was IDD-associated increased by nearly 10% each year (prevalence ratio of IDD per year: 1.09, 95% CI: 1.05–1.14). Patients with IDDIE had longer hospital stays [median days (interquartile range); IDD-IE, 17 (10–29); non-IDD-IE, 10 (6–18); P = 0.001] with almost twice the cost of admission as those without IDD [median (interquartile range); IDD-IE, $47,899 ($24,578–78,144); non-IDD-IE, $26,460 ($10,220–60,059); P = 0.001]. In 52% of cases, there was no documentation of any discussion regarding addiction treatment. Conclusion IDD-IE cases are increasing in Virginia leading to higher morbidity and healthcare costs. IDD-IE may provide an opportunity for the delivery of IDD treatment, counseling, and harm reduction strategies. Disclosures All authors: No reported disclosures.

scholarly journals Inconsistent Addiction Treatment for Patients Undergoing Cardiac Surgery for Injection Drug Use-associated Infective Endocarditis

2020 ◽  
Vol 14 (6) ◽  
pp. e350-e354
Author(s):  
Max Jordan Nguemeni Tiako ◽  
Seong Hong ◽  
Syed Usman Bin Mahmood ◽  
Makoto Mori ◽  
Abeel Mangi ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Addiction Treatment ◽  
Injection Drug

scholarly journals Patients with infective endocarditis and history of injection drug use in a Swedish referral hospital during 10 years

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Damlin ◽  
Katarina Westling
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Clinical Characteristics ◽  
National Registry ◽  
Injection Drug ◽  
University Hospital ◽  
Prosthetic Heart Valves ◽  
Increased Risk ◽  
History Of

Abstract Background Patients with injection drug use (IDU) have increased risk of developing infective endocarditis (IE). Previous studies have reported recurrent IE, increased duration of hospital stay, poor adherence and compliance as well as higher mortality and worse outcomes after surgery in the IDU-IE patient group. Further studies are needed to provide a basis for optimized care and prevention of readmissions in this population. This study aims to describe the clinical characteristics and outcomes among patients with IDU-IE. Methods Data of adults with IDU-IE and non-IDU-IE, treated between 2008 and 2017 at the Karolinska University Hospital in Stockholm were obtained from the Swedish National Registry of Infective Endocarditis. Clinical characteristics, microbiological results, treatment durations, results from echocardiography and in-hospital mortality were compared between the groups. Results Of the total 522 patients, 165 (32%) had IDU-IE. Patients with IDU-IE were younger than the patients with non-IDU-IE (mean age IDU-IE: 41.6 years, SD 11.9 years; non-IDU-IE: 64.3 years, SD 16.4 years; P <  0.01). No difference in distribution of gender was observed, 33% were females in both the IDU-IE and the non-IDU-IE group. History of previous IE (IDU-IE: n = 49, 30%; non-IDU-IE: n = 34, 10%; P <  0.01) and vascular phenomena (IDU-IE: n = 101, 61%; non-IDU-IE: n = 120, 34%; P <  0.01) were more common among patients with IDU-IE while prosthetic heart valves (IDU-IE: n = 12, 7%; non-IDU-IE: n = 83, 23%; P <  0.01) and known valvular disease (IDU-IE: n = 3, 2%; non-IDU-IE: n = 78, 22%; P <  0.01) were more common among patients with non-IDU-IE. Aetiology of Staphylococcus aureus (IDU-IE: n = 123, 75%; non-IDU-IE: n = 118, 33%; P <  0.01) as well as tricuspid (IDU-IE: n = 91, 55%; non-IDU-IE: n = 23, 6%; P <  0.01) or pulmonary valve vegetations (IDU-IE: n = 7, 4%; non-IDU-IE: n = 2, 1%; P <  0.01) were more common in the IDU-IE group. The overall incidence of IDU-IE decreased during the study period, while the incidence of definite IE increased (P <  0.01). Conclusions This study presents that patients with IDU-IE were younger, less frequently treated with surgery and had higher prevalence of vascular phenomena and history of previous IE, aspects that are important for improved management of this population.

Infective endocarditis secondary to injection drug use: A survey of Canadian cardiac surgeons

2021 ◽  
Author(s):  
Kevin R. An ◽  
Jessica G.Y. Luc ◽  
Derrick Y. Tam ◽  
Olina Dagher ◽  
Rachel Eikelboom ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Cardiac Surgeons

scholarly journals Injection Drug Use–Associated Infective Endocarditis

JAMA ◽  
2018 ◽  
Vol 320 (18) ◽  
pp. 1939 ◽  
Author(s):  
David Phillip Serota ◽  
J. Deanna Wilson ◽  
Jessica S. Merlin
Keyword(s):  
Infective Endocarditis ◽  
Drug Use ◽  
Injection Drug Use ◽  
Injection Drug

scholarly journals Blood culture time to positivity in non-β-hemolytic streptococcal bacteremia as a predictor of infective endocarditis—a retrospective cohort study

2021 ◽  
Author(s):  
David Krus ◽  
Fredrik Kahn ◽  
Bo Nilson ◽  
Torgny Sunnerhagen ◽  
Magnus Rasmussen
Keyword(s):  
Cohort Study ◽  
Infective Endocarditis ◽  
Blood Culture ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Population Based ◽  
Culture Time ◽  
Time To Positivity

AbstractNon-β-hemolytic streptococci (NBHS) cause infective endocarditis (IE) and a short blood culture time to positivity (TTP) is associated with risk of IE in bacteremia with other pathogens. In this retrospective population-based cohort study, we investigate if TTP is associated to IE or mortality. Of 263 episodes with NBHS bacteremia, 28 represented IE and the median TTP did not differ significantly between episodes with IE (15 h) and non-IE (15 h) (p=0.51). TTP was similar among those who survived and those who died within 30 days. However, TTP significantly differed when comparing the different streptococcal groups (p<0.001).

Sign in / Sign up

Export Citation Format

Share Document