Risk practices associated with bacterial infections among injection drug users in Denver, Colorado

Abstract

Background: There has been limited research on bacterial infections (e.g., skin and soft tissue abscesses, endocarditis) among injection drug users (IDUs), despite these infections often resulting in serious morbidity and costly medical care. Although high-risk practices that contribute to bacterial infections are not entirely clear, certain injection practices have been found to increase risk in past studies.

Objectives: The objectives of this study are to examine rates of bacterial infections among IDUs in Denver, Colorado, and high-risk practices that predict skin infections.

Methods: Structured interviews were conducted with 51 active heroin, cocaine, and methamphetamine IDUs (over 18 years).

Results: Among all participants, 55% reported a lifetime history of at least one skin infection, and 29% reported having an infection in the last year. Those with a skin infection in the last year were significantly more likely to inject intramuscularly (OR = 1.57) and to report greater heroin injection frequency (OR = 1.08) compared to IDUs with no history of skin infections. Heroin and speedball injectors reported a higher number of past abscesses compared to methamphetamine and cocaine injectors.

Conclusion: Intervention strategies to reduce bacterial infections should focus on high-risk injection practices.

Scientific significance: Learning about rates of bacterial infections and high-risk practices associated with these infections can benefit researchers developing risk reduction interventions for IDUs.