Allaw Fatima, Zakhour Johnny, Kanj Souha S
Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon.
Curr Opin Infect Dis. 2023 Apr 1;36(2):67-73. doi: 10.1097/QCO.0000000000000902. Epub 2023 Jan 25.
The aim of this review is to discuss the latest evidence of the epidemiology, microbiology, risk factors, diagnosis and management of community-acquired skin and soft tissue infections (SSTIs) in people who inject drug (PWID).
SSTIs are common complications in PWID and a major cause of morbidity and mortality. Infections can range from uncomplicated cellulitis, to abscesses, deep tissue necrosis and necrotizing fasciitis. They are predominantly caused by Gram-positive pathogens in particular Staphylococcus aureus and Streptococcus species; however, toxin-producing organisms such as Clostridium botulism or Clostridium tetani should be considered. The pathogenesis of SSTI in the setting of intravenous drug use (IDU) is different from non-IDU related SSTI, and management often requires surgical interventions in addition to adjunctive antibiotics. Harm reduction strategies and education about safe practices should be implemented to prevent morbidity and mortality as well as healthcare burden of SSTI in PWID.
Prompt diagnosis and proper medical and surgical management of SSTI will improve outcomes in PWID.
本综述旨在探讨注射吸毒者社区获得性皮肤和软组织感染(SSTI)的流行病学、微生物学、危险因素、诊断及管理方面的最新证据。
SSTI是注射吸毒者常见的并发症,也是发病和死亡的主要原因。感染范围从不复杂的蜂窝织炎到脓肿、深部组织坏死和坏死性筋膜炎。它们主要由革兰氏阳性病原体引起,特别是金黄色葡萄球菌和链球菌属;然而,也应考虑产毒素的生物体,如肉毒梭菌或破伤风梭菌。静脉吸毒(IDU)情况下SSTI的发病机制与非IDU相关的SSTI不同,管理通常除辅助使用抗生素外还需要手术干预。应实施减少伤害策略和安全操作教育,以预防注射吸毒者中SSTI的发病、死亡以及医疗负担。
对SSTI进行及时诊断以及适当的医疗和手术管理将改善注射吸毒者的治疗结果。