Taylor A, Hutchinson S, Lingappa J, Wadd S, Ahmed S, Gruer L, Taylor T H, Roy K, Gilchrist G, McGuigan C, Penrice G, Goldberg D
Institute for Applied Social and Health Research, School of Social Sciences, University of Paisley, High Street, Paisley PA1 2BE, Scotland, UK.
Epidemiol Infect. 2005 Apr;133(2):193-204. doi: 10.1017/s0950268804003504.
Between April and September 2000, 60 injecting drug users in Scotland died or were hospitalized with severe illness. Laboratory investigations suggested that Clostridium novyi and other bacteria were important aetiological agents. To determine associated environmental/behavioural factors a case-control study was undertaken with 19 'definite' and 32 'probable' cases in Glasgow, Scotland. For every deceased case (n=19), up to three proxy individuals were interviewed. Three controls were identified for each case. Multivariate logistic regression analyses compared (i) all cases and controls; (ii) definite cases and matched controls; (iii) probable cases and matched controls. In all three analyses injecting into muscle or skin and injecting most of the time with a filter used by someone else were the variables most strongly associated with illness. Comparing only muscle-injecting cases and controls, cases were significantly more likely to have injected larger amounts of heroin per average injection than were controls. The findings make an important epidemiological contribution to the understanding of the public health and clinical implications of the contamination of illicit drugs by histotoxic clostridia.
2000年4月至9月期间，苏格兰有60名注射吸毒者死亡或因重病住院。实验室调查表明，诺维氏梭菌和其他细菌是重要的病原体。为了确定相关的环境/行为因素，在苏格兰格拉斯哥对19例“确诊”病例和32例“疑似”病例进行了病例对照研究。对于每一例死亡病例（n = 19），最多对三名替代个体进行了访谈。为每例病例确定了三名对照。多变量逻辑回归分析比较了：（i）所有病例与对照；（ii）确诊病例与匹配对照；（iii）疑似病例与匹配对照。在所有三项分析中，肌肉或皮肤注射以及大多数时候使用他人用过的过滤器进行注射是与疾病关联最密切的变量。仅比较肌肉注射的病例与对照时，病例平均每次注射海洛因的量明显多于对照。这些发现为理解组织毒性梭菌污染非法药物对公共卫生和临床的影响做出了重要的流行病学贡献。
