Wheeler Alice, Masters Jeffrey, Pradhan Alyssa, Roth Jess Monineath, Degenhardt Louisa, Dore Gregory J, Matthews Gail V, Cunningham Evan B, Peacock Amy, Colledge-Frisby Samantha, Grebely Jason, Hajarizadeh Behzad, Martinello Marianne
The Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Department of Infectious Diseases, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Open Forum Infect Dis. 2025 Feb 24;12(4):ofaf108. doi: 10.1093/ofid/ofaf108. eCollection 2025 Apr.
Despite the increasing burden of injection-related bacterial and fungal infections, there has been no recent synthesis of their epidemiology. We performed a systematic review and meta-analysis evaluating the prevalence and incidence of injection-related infections among people who inject drugs.
We searched EMBASE, MEDLINE, Web of Science, and PsycINFO for articles published since 1 January 2010. Eligible studies assessed the prevalence or incidence of ≥1 injection-related infection among people who recently injected drugs. Random-effects meta-analysis was used to calculate pooled estimates of infection prevalence, according to infection type and prevalence period.
Of 8097 articles identified, 87 were eligible for inclusion (prevalence, 78; incidence, 9). Data were available for 25 countries, including 10 low- or middle-income countries. The prevalence of skin and soft-tissue infections (including skin abscess and cellulitis) was 13% in the past month (95% confidence interval [CI], 9%-19% [11 studies]), 30% in the past 3-12 months (23%-37% [23 studies]), and 47% across the lifetime (29%-66% [7 studies]). The prevalence of endocarditis was 2% in the past month (95% CI, 1%-3% [4 studies]), 2% in the past 3-12 months (2%-3% [5 studies]), and 6% across the lifetime (3%-10% [8 studies]). Prevalence of sepsis and/or bloodstream infection was 1% in the past month (95% CI, 1%-2% [2 studies]), 7% in the past 3-12 months (4%-13% [3 studies]), and 8% across the lifetime (3%-19% [5 studies]).
Injection-related infections are a common complication of injecting drug use. Interventions to reduce their occurrence and associated disease burden are needed.
尽管注射相关的细菌和真菌感染负担日益加重，但近期尚无关于其流行病学的综合研究。我们进行了一项系统评价和荟萃分析，以评估注射毒品者中注射相关感染的患病率和发病率。
我们检索了EMBASE、MEDLINE、Web of Science和PsycINFO中自2010年1月1日以来发表的文章。符合条件的研究评估了近期注射毒品者中≥1种注射相关感染的患病率或发病率。采用随机效应荟萃分析，根据感染类型和患病时期计算感染患病率的合并估计值。
在检索到的8097篇文章中，87篇符合纳入标准（患病率研究78篇，发病率研究9篇）。数据来自25个国家，包括10个低收入或中等收入国家。过去1个月皮肤和软组织感染（包括皮肤脓肿和蜂窝织炎）的患病率为13%（95%置信区间[CI]，9%-19%[11项研究]），过去3至12个月为30%（23%-37%[23项研究]），终生患病率为47%（29%-66%[7项研究]）。过去1个月心内膜炎的患病率为2%（95%CI，1%-3%[4项研究]），过去3至12个月为2%（2%-3%[5项研究]），终生患病率为6%（3%-10%[8项研究]）。过去1个月脓毒症和/或血流感染的患病率为1%（95%CI，1%-2%[2项研究]），过去3至12个月为7%（4%-13%[3项研究]），终生患病率为8%（3%-19%[5项研究]）。
注射相关感染是注射毒品使用的常见并发症。需要采取干预措施以减少其发生及相关疾病负担。
