Department of Infectious Diseases, the Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia
Department of Infectious Diseases, the Alfred Hospital and Central Clinical School, Monash University, Melbourne, Victoria, Australia.
BMJ Open. 2023 Apr 3;13(4):e070236. doi: 10.1136/bmjopen-2022-070236.
People who inject drugs (PWID) are at risk of invasive infections such as bloodstream infections, endocarditis, osteomyelitis and septic arthritis. Such infections require prolonged antibiotic therapy, but there is limited evidence about the optimal care model to deliver to this population. The Epidemiology and Management of invasive infections among people who Use drugs (EMU) study aims to (1) describe the current burden, clinical spectrum, management and outcomes of invasive infections in PWID; (2) determine the impact of currently available models of care on completion of planned antimicrobials for PWID admitted to hospital with invasive infections and (3) determine postdischarge outcomes of PWID admitted with invasive infections at 30 and 90 days.
EMU is a prospective multicentre cohort study of Australian public hospitals who provide care to PWIDs with invasive infections. All patients who have injected drugs in the previous six months and are admitted to a participating site for management of an invasive infection are eligible. EMU has two components: (1) EMU-Audit will collect information from medical records, including demographics, clinical presentation, management and outcomes; (2) EMU-Cohort will augment this with interviews at baseline, 30 and 90 days post-discharge, and data linkage examining readmission rates and mortality. The primary exposure is antimicrobial treatment modality, categorised as inpatient intravenous antimicrobials, outpatient antimicrobial therapy, early oral antibiotics or lipoglycopeptide. The primary outcome is confirmed completion of planned antimicrobials. We aim to recruit 146 participants over a 2-year period.
EMU has been approved by the Alfred Hospital Human Research Ethics Committee (Project number 78815.) EMU-Audit will collect non-identifiable data with a waiver of consent. EMU-Cohort will collect identifiable data with informed consent. Findings will be presented at scientific conferences and disseminated by peer-review publications.
ACTRN12622001173785; Pre-results.
注射毒品者（PWID）面临着侵袭性感染的风险，如血流感染、心内膜炎、骨髓炎和化脓性关节炎。此类感染需要长期的抗生素治疗，但针对该人群的最佳治疗模式的证据有限。使用毒品者侵袭性感染的流行病学和管理（EMU）研究旨在：（1）描述 PWID 侵袭性感染的当前负担、临床谱、管理和结局；（2）确定目前可用的护理模式对 PWID 因侵袭性感染入院完成计划抗生素治疗的影响；（3）确定 30 天和 90 天因侵袭性感染入院的 PWID 的出院后结局。
EMU 是一项针对澳大利亚公立医院的前瞻性多中心队列研究，为接受侵袭性感染的 PWID 提供治疗。所有在过去六个月内注射过毒品且因管理侵袭性感染而入住参与研究地点的患者均符合条件。EMU 有两个部分：（1）EMU-Audit 将从病历中收集信息，包括人口统计学、临床表现、管理和结局；（2）EMU-Cohort 将通过基线、30 天和 90 天出院后访谈以及数据链接来补充这些信息，以检查再入院率和死亡率。主要暴露因素是抗菌治疗方式，分为住院静脉内抗生素、门诊抗生素治疗、早期口服抗生素或糖肽。主要结局是确认完成计划的抗生素治疗。我们计划在两年内招募 146 名参与者。
EMU 已获得阿尔弗雷德医院人类研究伦理委员会的批准（项目编号 78815.）EMU-Audit 将收集无身份识别数据，并豁免同意。EMU-Cohort 将收集可识别数据并获得知情同意。研究结果将在科学会议上报告，并通过同行评审出版物传播。
ACTRN12622001173785；预结果。
