‘Popping’: a cause of soft tissue sepsis in chronic drug abusers

Graham, Cynthia A.; Gw, McNaughton; Crawford, Rachel

doi:10.1097/00063110-199909000-00016

Cited by 10 publications

(6 citation statements)

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“…Practices such as skin or muscle popping (intentionally or accidentally injecting into skin or muscle) ( 10 , 27 , 28 ) or the use of large amounts of citric acid to dissolve heroin can damage soft tissue, leading to necrosis and providing a suitable environment for anaerobic bacteria, such as Clostridium spp., to thrive. Older age (a proxy for a longer injecting career) and female sex have been associated with infections and injuries at injecting sites ( 29 , 30 ), which are associated with difficulty accessing veins.…”

Section: Discussionmentioning

confidence: 99%

Infections with Spore-forming Bacteria in Persons Who Inject Drugs, 2000–2009

Palmateer¹,

Hope²,

Roy³

et al. 2013

Emerg. Infect. Dis.

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Section: Discussionmentioning

confidence: 99%

Infections with Spore-forming Bacteria in Persons Who Inject Drugs, 2000–2009

Palmateer¹,

Hope²,

Roy³

et al. 2013

Emerg. Infect. Dis.

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“…The third hypothesis -IDUs who injected intramuscularly or subcutaneously were more likely to be affected -was well supported by the finding of a high odds ratio on multivariate analysis for this behaviour. Skin popping has been strongly associated with IDUassociated soft-tissue infection involving anaerobic bacilli [16][17][18], staphylococci, streptococci [19], and abscesses lacking an identified microbiological cause [20,21].…”

Section: Discussionmentioning

confidence: 99%

Severe illness and death among injecting drug users in Scotland: a case-control study

et al. 2004

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Between April and September 2000, 60 injecting drug users in Scotland died or were hospitalized with severe illness. Laboratory investigations suggested that Clostridium novyi and other bacteria were important aetiological agents. To determine associated environmental/behavioural factors a case-control study was undertaken with 19 'definite' and 32 'probable' cases in Glasgow, Scotland. For every deceased case (n=19), up to three proxy individuals were interviewed. Three controls were identified for each case. Multivariate logistic regression analyses compared (i) all cases and controls; (ii) definite cases and matched controls; (iii) probable cases and matched controls. In all three analyses injecting into muscle or skin and injecting most of the time with a filter used by someone else were the variables most strongly associated with illness. Comparing only muscle-injecting cases and controls, cases were significantly more likely to have injected larger amounts of heroin per average injection than were controls. The findings make an important epidemiological contribution to the understanding of the public health and clinical implications of the contamination of illicit drugs by histotoxic clostridia.

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“…Injecting anaerobic bacterial spores intravenously will not provide an environment suitable for spore germination and multiplication of vegetative cells that produce the toxins. Skin-and muscle-popping lead to new 'niches ' for microbial pathogens to fill and are major risk factors for the development of infections [1,2,10]. These injection routes may be used once intravenous injection is no longer possible or in preference to that route.…”

Section: Risk Factors : Idu Behaviourmentioning

confidence: 99%

Soft tissue infections caused by spore-forming bacteria in injecting drug users in the United Kingdom

Brett¹,

Hood

Brazier

et al. 2005

Epidemiol. Infect.

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From 2000 to May 2004 there has been a marked increase in illness resulting from spore-forming bacteria in injecting heroin users in the United Kingdom. Clostridium novyi caused 63 cases of severe illness in 2000 and seven further cases from 2001. Wound botulism first occurred in 2000 (six cases) with 51 further cases to March 2004. Tetanus occurred in 20 cases between late 2003 and March 2004. Infections with C. histolyticum (nine cases), C. sordellii (one case) and Bacillus cereus (one case) were also reported. The reasons for the increase in illness are unclear. The major risk factor was skin- or muscle-popping. The problem appears to be here to stay. This review describes the causative organisms, pathogenesis, clinical presentation, epidemiology and treatment of cases. Clinical vigilance and a high standard of anaerobic microbiology are essential. Clinicians and laboratories must report such cases (or likely cases) rapidly so that clusters can be rapidly identified, in order to control disease. Prevention relies on tetanus immunization.

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‘Popping’: a cause of soft tissue sepsis in chronic drug abusers

Cited by 10 publications

References 0 publications

Infections with Spore-forming Bacteria in Persons Who Inject Drugs, 2000–2009

Infections with Spore-forming Bacteria in Persons Who Inject Drugs, 2000–2009

Severe illness and death among injecting drug users in Scotland: a case-control study

Soft tissue infections caused by spore-forming bacteria in injecting drug users in the United Kingdom

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