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

Abstract

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.

Bacillus cereus , a Volatile Human Pathogen

“…Depending upon the environment in which the trauma takes place, e.g., fresh or salt water or soil, recognized microbial species such as Pseudomonas aeruginosa or Aeromonas or Vibrio species predominate (107), whereas Bacillus species isolated from trauma-induced wounds, whether water related or not, are usually regarded as contaminants and basically ignored until a more dramatic complication such as, for example, sepsis or necrotizing fasciitis occurs and is attributed to the bacillary species. In recent years, however, the recognition of B. cereus as a major pathogen infecting individuals who sustain traumatic injuries is being well documented (2,22,42,81,107). Because of the wide environmental distribution of B. cereus spores, especially in soil, they can easily disseminate through dust, water, and food.…”

Not in the vein: ‘missed hits’, subcutaneous and intramuscular injections and associated harms among people who inject psychoactive drugs in Bristol, United Kingdom

“…Intentional or accidental subcutaneous and intramuscular injections among people who inject psychoactive drugs are known to be a risk factor for injection related bacterial infections (Binswanger, Kral, Bluthenthal, & Rybold, 2000;Pirozzi, Van, Pontious, & Meyr, 2014), particularly those caused by anaerobic organisms, such as, wound botulism and tetanus (CDC, 1995;Brett, Hood, Brazier, Duerden, & Hahne, 2005;Palmateer, et al, 2013).…”

Phylogenetic Analysis of Bacillus cereus Isolates from Severe Systemic Infections Using Multilocus Sequence Typing Scheme

“…Recent publications have acknowledged its importance as a causative agent of severe systemic infections, mainly in immunocompromised individuals. Reported cases include meningoencephalitis (21), soft tissue infections (6), bacteremia in immunocompromised patients (8,12), pneumonia (13), liver abscess (20), keratitis (24), osteomyolitis (28), endocarditis (31) and post-trauma wound infection (2).…”