Background: Prescriptions for opioid medications has increased during the past two decades. In 2016, there were 17,087 deaths involving prescription opioids, or approximately 46 deaths per day. This is a significant increase from 15,281 in 2015 (p < 0.05). The use of injectable opioids are often associated with skin infections, such as Methicillin-resistant Staphylococcus aureus (MRSA). The purpose of this study is to examine the association between opioid dependence and MRSA colonization or infection in hospitalized patients in Florida during 2009-2016. Methods: Florida's Agency for Health Care Administration (AHCA) database was used for this study and includes discharge data from 299 hospitals in Florida. Patients 18 years or older with diagnoses of opioid dependence or MRSA infection or colonization were identified. Admissions to psychiatric and rehabilitation hospitals were not included in the analysis. Data was aggregated by the 11 Local Health Council (LHC) regions and includes all 67 counties. Results: We examined more than 17 million hospitals admissions reported to AHCA between 2009 and 2016. We identified 177,752 (1.0%) admissions of patients with opioid dependence diagnosis, and 359,420 (2.1%) admissions of patients with MRSA. The rate of opioid dependence increased from 5.3 per 1,000 hospital admissions in 2009 to 16.6 in 2016. Substantial increases were evident in all LHC regions. MRSA infections were identified in 8,345 (4.7%) of the admissions of patients with opioid dependence, and in 351,075 (2.0%) of the patients without opioid dependence. The patients in opioid dependence group were 2.4 times more likely to have a MRSA diagnosis compared to the patients in non-opioid dependence group (OR = 2.38, 95% CI 2.33, 2.43, p < 0.001). Significant association between opioid dependence and MRSA was found in all LHC regions. Conclusions: This study identified significant associations between opioid dependence and MRSA infection or colonization, overall, and in all LHC regions. Although preventive efforts such as screening, isolation, and handwashing are taking place in hospitals and communities, the findings illustrate the importance of implementing routine screening for MRSA in people with opioid dependence, as well in bringing awareness about MRSA transmission within communities.
Objective: As the opioid addiction epidemic continues to grow, other serious health issues regarding drug use has also increased. This study examines the trends in admissions and population characteristics of those who experience infective endocarditis with opioid drug dependence.Methods: We used ICD-9-CM and ICD-10-CM codes to identify patients admitted to a hospital with infective endocarditis and with a secondary diagnosis of opioid use related disorders using data released by the Florida Agency for Health Care Administration (AHCA). Data included age, gender, ethnicity, race, discharge disposition, admission type, payer status, total charges, and zip code of patients’ residence.Results: During the four-year period, the percent of patients diagnosed with infective endocarditis and a diagnosis code associated with opioid abuse or dependence doubled (4.48% to 8.52%). Of the patients dually diagnosed, the mean age was 37.47 and the majority were white (90.78%), non-Hispanic (91.96%), and female (58.55%). Nearly 47% of the patients did not have health insurance. The percentage of patients with both diagnosis codes living in urban counties was 91.37%. Median length of stay was 10 days and median total charges for patients was $101,604.Conclusions: With the increasing incidence of opioid dependence and addiction within the United States, there is a rise in infective endocarditis, a costly and debilitating disease. Our analysis provides the framework for hospital systems to identify patients who may benefit from addiction services, which through downstream effects will cause less of a health and financial burden.
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