Wounds and Skin and Soft Tissue Infections in People Who Inject Drugs and the Utility of Syringe Service Programs in Their Management

Sanchez, Daniela P.; Tookes, Hansel; Pastar, Irena; Lev‐Tov, Hadar

doi:10.1089/wound.2020.1243

Cited by 25 publications

(19 citation statements)

References 67 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Providing sterile injection equipment and exchanging needles may be an additional strategy to reduce the incidence of IDU associated SSTIs. Although needle exchange programmes were originally conceived to lower the risk of bloodborne infections such as HIV, they had a positive impact on reducing SSTIs [18,43]. Moreover, SSTIs may be reduced in supervised use spaces [6].…”

Section: Preventionmentioning

confidence: 99%

“…Most SSTIs in PWID originate from organisms that colonize the skin, which are introduced via injection or from pathogens contaminating the injected material. Skin popping, defined as subcutaneous or intradermal injection, is considered to be the main risk factor associated with cellulitis [7 ▪▪ ,17,18,19 ▪▪ ]. In addition, repeated injections at the same anatomical site can lead to venous and nerves damages that predispose to infections [16].…”

Section: Pathogenesis and Risk Factorsmentioning

confidence: 99%

“…In addition, repeated injections at the same anatomical site can lead to venous and nerves damages that predispose to infections [16]. Moreover, injections into the lower extremities will cause venous damage that subsequently leads to chronic venous disease followed by local oedema, varicose veins formation and refractory skin ulcers, all being risk factors for superimposed bacterial infections [7 ▪▪ ,18]. Notably, injections into the femoral veins (or groin area) have been correlated with bacteraemia, sepsis, DVT and HCV infection [20].…”

Section: Pathogenesis and Risk Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Community-acquired skin and soft-tissue infections in people who inject drugs

Allaw¹,

Zakhour²,

Kanj³

2023

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

Purpose of reviewThe aim of this review is to discuss the latest evidence of the epidemiology, microbiology, risk factors, diagnosis and management of community-acquired skin and soft tissue infections (SSTIs) in people who inject drug (PWID). Recent findingsSSTIs are common complications in PWID and a major cause of morbidity and mortality. Infections can range from uncomplicated cellulitis, to abscesses, deep tissue necrosis and necrotizing fasciitis. They are predominantly caused by Gram-positive pathogens in particular Staphylococcus aureus and Streptococcus species; however, toxin-producing organisms such as Clostridium botulism or Clostridium tetani should be considered. The pathogenesis of SSTI in the setting of intravenous drug use (IDU) is different from non-IDU related SSTI, and management often requires surgical interventions in addition to adjunctive antibiotics. Harm reduction strategies and education about safe practices should be implemented to prevent morbidity and mortality as well as healthcare burden of SSTI in PWID. SummaryPrompt diagnosis and proper medical and surgical management of SSTI will improve outcomes in PWID.

show abstract

Section: Preventionmentioning

confidence: 99%

Section: Pathogenesis and Risk Factorsmentioning

confidence: 99%

Section: Pathogenesis and Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Community-acquired skin and soft-tissue infections in people who inject drugs

Allaw¹,

Zakhour²,

Kanj³

2023

Current Opinion in Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…Yet, vulnerable and marginalized populations continue to lack access to these basic services [ 2 ]. Basic WASH access helps prevent water-related diseases such as malnutrition, myocarditis, viral, protozoan, helminth or bacterial infections, and even multidrug-resistant organisms [ 3 ], which can cause death or compromise people’s health. Furthermore, WASH access and insecurity became critically important during the recent pandemic outbreaks.…”

Section: Introductionmentioning

confidence: 99%

Water, sanitation, and hygiene access among people who inject drugs in Tijuana and San Diego in 2020–2021: a cross-sectional study

Calderón-Villarreal,

Avelar Portillo,

Abramovitz

et al. 2024

Int J Equity Health

View full text Add to dashboard Cite

Background Water, sanitation, and hygiene (WASH) access is critical to public health and human dignity. People who inject drugs (PWID) experience stigma and structural violence that may limit WASH access. Few studies have assessed WASH access, insecurity, and inequities among PWID. We describe WASH access, social and geographic inequalities, and factors associated with WASH insecurity among PWID in the Tijuana-San Diego metropolitan area. Methods In this cross-sectional binational study, we interviewed PWID (age 18+) in 2020–2021 about WASH access and insecurity. City of residence (Tijuana/San Diego) and housing status were considered as independent variables to describe key WASH access outcomes and to assess as factors associated with WASH insecurity outcomes. Measures of association between outcomes and independent variables were assessed using log modified-Poisson regression models adjusting for covariates. Results Of 586 PWID (202 Tijuana; 384 San Diego), 89% reported basic access to drinking water, 38% had basic hand hygiene, 28% basic sanitation, and 46% access to bathing, and 38% reported recent open defecation. Participants residing in Tijuana reported significantly higher insecurity in accessing basic drinking water (aRR: 1.68, 95%CI: 1.02–2.76), basic hygiene (aRR: 1.45, 95%CI: 1.28–1.64), and bathing (aRR: 1.21, 95%CI: 1.06–1.39) than those living in San Diego. Participants experiencing unsheltered homelessness experienced significantly higher insecurity in accessing basic drinking water (aRR: 2.03, 95%CI: 1.07–3.86), basic sanitation (aRR: 1.68, 95%CI: 1.48, 1.92), bathing (aRR: 1.84, 95%CI: 1.52–2.22), and improved water sources for cleaning wounds (aRR: 3.12, 95%CI: 1.55–6.29) and for preparing drugs (aRR: 2.58, 95%CI: 1.36–4.89) than participants living in permanent housing. Conclusion WASH access among PWID in the Tijuana-San Diego metropolitan area was low by international standards and lower than the national averages in both countries. Homelessness was significantly associated with WASH insecurity in this population. Concentrated efforts are needed to guarantee continuously available WASH services for PWID—especially those who are unsheltered.

show abstract

“…Persons who inject drugs (PWID) intravenously normally aim to inject a vein using a hypodermic needle and syringe 1 . When they miss the vein (missed hit) it may lead to skin and soft tissue injuries (SSTIs), cellulitis and/or abscess formation in varied anatomical sites [2][3][4][5][6][7][8][9][10][11] . An abscess contains a collection of pus in the dermis or sub-dermis and is characterised by pain, tenderness, redness, inflammation and infection 12 .…”

Section: Introductionmentioning

confidence: 99%

Self-treatment of abscesses by persons who inject intravenous drugs: a community-based quality improvement inquiry

Kuhnke¹,

Malik²,

Maxwell³

et al. 2023

wcet

View full text Add to dashboard Cite

Objective This study had two objectives. First, to understand and then describe the experiences of persons who inject drugs (PWID) and who use self-care treatment(s) to deal with resulting skin and tissue abscesses. Next, to understand and describe their journeys to and experiences with formal healthcare service provision.Methods Semi-structured interviews were conducted with ten adults who have experience with abscesses, engage in self-care treatment(s), and utilise formal healthcare services in Nova Scotia, Canada. ResultsParticipants lived with abscesses and utilised various self-treatment strategies, including support from friends. Participants engaged in progressive self-care treatment(s) as the abscesses worsened. They reluctantly made use of formal healthcare services. Finally, participants discussed the importance of education. Moreover, they shared their thoughts in terms of how service provision could be improved.Conclusions Participants described their lives, including their journeys to intravenous drug use. They also described the self-care treatments they used to heal resulting abscesses. They used these self-care treatments because of a reluctance to utilise formal healthcare services. From a quality improvement perspective, participants outlined suggestions for: 1) expanding hours of service at the community wound care clinic and the centre; 2) permitting pharmacists to include prescribing topical and oral antibiotics; 3) promoting abscess prevention education for clients and healthcare providers; and 4) promising practices for the provision of respectful care during emergency care visits.Keywords abscesses, self-care treatment, persons who inject drugs, quality improvement For referencing Kuhnke JL et al. Self-treatment of abscesses by persons who inject intravenous drugs: a community-based quality improvement inquiry.

show abstract

Wounds and Skin and Soft Tissue Infections in People Who Inject Drugs and the Utility of Syringe Service Programs in Their Management

Cited by 25 publications

References 67 publications

Community-acquired skin and soft-tissue infections in people who inject drugs

Community-acquired skin and soft-tissue infections in people who inject drugs

Water, sanitation, and hygiene access among people who inject drugs in Tijuana and San Diego in 2020–2021: a cross-sectional study

Self-treatment of abscesses by persons who inject intravenous drugs: a community-based quality improvement inquiry

Contact Info

Product

Resources

About