Soft Tissue Infections in Parenteral Drug Abusers

Abstract

Thirty-four parenteral drug abusers admitted with soft tissue infections underwent bacteriologic and immunologic evaluation. Staphylococcus aureus and beta hemolytic streptococci were the most common organisms recovered. Enteric gram negative aerobes and oral flora were common and enteric anaerobes rare. Absolute lymphopenia and elevations in the IgA, IgG and IgM fractions of the immunoglobulins were common as were false positive VDRL examinations. Cutaneous anergy was found in 83% of the group and 70% of a simultaneously noninfected addict group. Staphylococcal carriage was frequent. Because of variation in the flora between this and other reported groups, ongoing bacteriologic surveillance could be a useful guide to initial antibiotic therapy. Differences in the pattern of immune reaction in this group when compared to different addict groups suggest a difference in antigenic stimulation, possibly as a result of differences in bacteriologic exposure.

Exposure-Response Analyses of Tigecycline Efficacy in Patients with Complicated Skin and Skin-Structure Infections

“…Anaerobes can play an important role in skin infections, especially in diabetic foot infections (9) and bite wounds (20). The role of anaerobic bacteria in the pathogenesis of polymicrobial cellulitis in some patient populations, however, has been questioned (16). Since P. aeruginosa is intrinsically resistant to tigecycline, the presence of this organism at baseline was considered to determine whether there was a direct effect 1944 MEAGHER ET AL.…”

Necrotizing Soft Tissue Infection Masquerading as Cutaneous Abscess Following Illicit Drug Injection

“…Five patients had involvement of multiple areas, both trunk and extremities. The size of the wounds following debridement varied considerably (range, 15-783 cm 2 ). The extent of the wound area failed to correlate with the area of erythema, fluctuance, or induration.…”

“…4 Whereas hospitalization for infection following illicit drug use is es-timated to occur in more than one fourth of patients, the incidence of progression to NSTI in the drug-using population is not established. 2 Recently we observed a significant increase in NSTI, which has prompted further review of these infections. We were intrigued by the lack of clinical findings that differentiate simple subcutaneous abscess from more serious NSTI.…”

“…2 In excess of 700 000 patients are at risk in the United States each year. 3 The majority of such infections manifest as subcutaneous abscesses.…”

Purulent surgical infection caused by injection drug use (analytical review)

“…Orangio еt аl. [33] [28], аналізуючи дані мі-кробіологічного обстеження 78 хворих на наркоманію, дійшли висновку, що в 53 % випадків флора має полі-бактерійний характер, у 38 % наявна у вигляді моно-культури, у 9 % отримали стерильний висів з рани.…”