Health Protection Scotland, Glasgow, Scotland.
Emerg Infect Dis. 2013 Jan;19(1):29-34. doi: 10.3201/eid1901.120044.
Since 2000 in the United Kingdom, infections caused by spore-forming bacteria have been associated with increasing illness and death among persons who inject drugs (PWID). To assess temporal and geographic trends in these illnesses (botulism, tetanus, Clostridium novyi infection, and anthrax), we compared rates across England and Scotland for 2000-2009. Overall, 295 infections were reported: 1.45 per 1,000 PWID in England and 4.01 per 1,000 PWID in Scotland. The higher rate in Scotland was mainly attributable to C. novyi infection and anthrax; rates of botulism and tetanus were comparable in both countries. The temporal and geographic clustering of cases of C. novyi and anthrax into outbreaks suggests possible contamination of specific heroin batches; in contrast, the more sporadic nature of tetanus and botulism cases suggests that these spores might more commonly exist in the drug supply or local environment although at varying levels. PWID should be advised about treatment programs, injecting hygiene, risks, and vaccinations.
自 2000 年以来，在英国，与注射毒品者（PWID）相关的孢子形成细菌感染导致的疾病和死亡人数不断增加。为了评估这些疾病（肉毒中毒、破伤风、新型梭菌感染和炭疽）的时间和地理趋势，我们比较了 2000-2009 年英格兰和苏格兰的发病率。总体而言，报告了 295 例感染：英格兰每 1000 名 PWID 中有 1.45 例，苏格兰每 1000 名 PWID 中有 4.01 例。苏格兰较高的发病率主要归因于新型梭菌感染和炭疽；两国的破伤风和肉毒中毒发病率相当。新型梭菌和炭疽病例的时间和地理聚集表明，特定批次的海洛因可能受到污染；相比之下，破伤风和肉毒中毒病例的更分散性质表明，这些孢子可能更常见于毒品供应或当地环境中，尽管程度不同。应向 PWID 提供关于治疗方案、注射卫生、风险和疫苗接种的建议。
