Theme: Clinical Research Year: 2024
Background: Skin and soft tissue infections (SSTIs) are an important cause of morbidity and mortality among people who inject drugs (PWID). This study aims to assess the burden of SSTI in PWID and to identify risk factors for SSTI.
Methods: This is a cross-sectional study that includes consecutive PWID admitted to Gatehospitalet (The Street Hospital) in Norway. Gatehospitalet serves people who use drugs and is a 22-bed facility that provides in-patient care, including end-of-life care. The mean stay is approximately 3 weeks, and most patients have complex diseases including renal failure, dialysis, cancer, COPD, ulcers, and exhaustion.
The burden of SSTI was assessed through a structured interview. The primary outcome was Lifetime experience with hospitalizations due to SSTIs. The secondary outcome was risk factors for hospitalisation.
Results: Among the 70 patients, the mean age was 55 years, 47 (67%) were male, and 56 (80%) reported receiving opioid antagonist treatment (OAT). Recent injecting drug use was reported by 47 (70%, n=67). Nineteen patients (27%) reported having a fistula in the groin at the time of inclusion.
Hospitalisation due to an SSTI was reported by 52 (74%), of whom 34 (65%) were male and 18 (35%) were female. In unadjusted and adjusted analyses, neither age, gender, injection in the groin, nor non-venous injection were significantly associated with having been hospitalised due to an SSTI.
Moderate or severe SSTIs were reported by 60 (88% n=68). 55 (78%) reported having had a moderate or severe abscess, 24 (34%) reported moderate or severe cellulite, and 31 (44%) reported moderate or severe ulcer in their lifetime.
Conclusion: Three out of four PWID had ever been hospitalised due to an SSTI, and almost 9 out of 10 reported having had a moderate or serious SSTI.