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Appa does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.
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According to one study, people who use drugs experienced twice the hospital readmission rate and lower antibiotic completion rate for invasive Staphylococcus aureus infections than their non-drug-using counterparts.
Ayesha A. Appa
“As a first year Infectious Disease Fellow, I’ve seen countless cases of S. aureus bacteremia and other invasive infections. Patients often fell into two epidemiological groups, elderly, chronically ill patients with hospital-acquired infection, compared to healthier patients who consumed drugs, who often faced significant social challenges. ” Ayesha A. Appa, MD, Healio said, an Infectious Disease and Addiction Medicine Fellow at the University of California at San Francisco (UCSF) and Zuckerberg, San Francisco General.
Source: Appa AA et al. Clin Infect Dis. 2021; doi: 10.1093 / cid / ciab367.
“I feared that ID recommendations about optimal treatment for the latter group might not work as well and that no systems would be put in place for people who use drugs (PWUD) to be successful,” said Appa. “So we put together 5 years of S. aureus infections at UCSF to compare the results of these two patient groups.”
Appa and colleagues identified adults hospitalized at two San Francisco medical centers between 2013 and 2018 who had S. aureus bacteremia or ICD-encoded diagnoses of endocarditis, epidural abscess, or vertebral osteomyelitis with compatible culture. According to the study, in addition to comparing demographic and clinical characteristics, researchers constructed models for annual infection-related readmission and mortality, adjusted for age, race / ethnicity, housing, comorbidities, and MRSA.
The study included 963 hospitalizations for S. aureus infections in 946 patients. Of these, 372 (39%) occurred in PWUD. Heroin (198, 53%) and methamphetamine use (185, 50%) were common among these PWUDs.
Overall, the researchers found that PWUD had a lower antibiotic completion rate compared to non-PWUD (70% versus 87%; P <0.001), that drug use was not associated with increased mortality, and that 1-year readmission The rate of persistent or recurring infections was twice as high in PWUD compared to non-PWUD (28% versus 14%; adjusted HR = 2; 95% CI, 1.3-2.9).
The study also showed that MRSA was independently associated with 1-year readmission to infection (aHR = 1.5; 95% CI, 1.1-2.2), reported Appa and colleagues.
“PWUD with severe S. aureus infections should receive more effective, patient-centered treatment, and we need to develop more care models that combine substance use disorders and infection treatments,” said Appa.
She agrees with other experts that there should be a new ID sub-specialty for addiction in the future.
“As we found in our study, nearly 40% of these invasive S. aureus infections were in people who use drugs, and even if there are excellent life-saving drugs to treat opioid withdrawal or the use disorder, they have not been used adequately. ” Said Appa. “It’s not just about drugs, though. Both ID and addiction medicine professionals love the patient’s story, understand their social context and advocacy, so it goes really well together.”
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