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Review
. 2024 Jan;43(1):304-314.
doi: 10.1111/dar.13772. Epub 2023 Nov 23.

Epidemiology of acute infections in people who inject drugs in Australia

Lucy O Attwood  1 , Daniel O'Keefe  2 , Peter Higgs  2   3 , Olga Vujovic  1 , Joseph S Doyle  1   2 , Andrew J Stewardson  1
Affiliations
Review

Epidemiology of acute infections in people who inject drugs in Australia

Lucy O Attwood et al. Drug Alcohol Rev. 2024 Jan.

Abstract

Issues: People who inject drugs are at risk of acute infections, such as skin and soft tissue infections, infective endocarditis, bone and joint infections and bloodstream infections. There has been an increase in these infections in people who inject drugs internationally over the past 10 years. However, the local data regarding acute infections in Australia has not been well described.

Approach: We review the epidemiology of acute infections and associated morbidity and mortality amongst people who inject drugs in Australia. We summarise risk factors for these infections, including the concurrent social and psychological determinants of health.

Key findings: The proportion of people who report having injected drugs in the prior 12 months in Australia has decreased over the past 18 years. However, there has been an increase in the burden of acute infections in this population. This increase is driven largely by skin and soft tissue infections. People who inject drugs often have multiple conflicting priorities that can delay engagement in care.

Implications: Acute infections in people who inject drugs are associated with significant morbidity and mortality. Acute infections contribute to significant bed days, surgical requirements and health-care costs in Australia. The increase in these infections is likely due to a complex interplay of microbiological, individual, social and environmental factors.

Conclusion: Acute infections in people who inject drugs in Australia represent a significant burden to both patients and health-care systems. Flexible health-care models, such as low-threshold wound clinics, would help directly target, and address early interventions, for these infections.

Keywords: epidemiology; health systems; injecting drug use; sepsis; skin and soft tissue infections.

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Conflict of interest statement

Daniel O'Keefe has received investigator‐driven research funding from Gilead Sciences for work on hepatitis C unrelated to this manuscript. Peter Higgs has received investigator‐driven research funding from Gilead Sciences and AbbVie for work on hepatitis C unrelated to this manuscript. Joseph S. Doyle's institution has received investigator‐initiated research funding from Gilead Sciences and AbbVie and honoraria from Gilead Sciences and AbbVie. Andrew J. Stewardson's institution has received investigator‐initiated research funding from Merck, Sharp and Dohme. All other authors declare no competing interests.

Figures

FIGURE 1
FIGURE 1
Intersecting factors contributing to the occurrence of acute infections in people who inject drugs.
See this image and copyright information in PMC

References

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