Roberts Kate E A, Okumu Eunice A, McInnes Bailey, Ostrach Bayla, Chu Vivian H, Wu Li-Tzy, Golin Carol, Rosen David L, Schranz Asher J
Graduate School of Social Work and Social Research, Bryn Mawr College, Bryn Mawr, PA, USA.
Aurrera Health Group, Sacramento, CA, USA.
Subst Use Addctn J. 2025 Jul 22:29767342251351759. doi: 10.1177/29767342251351759.
Infective endocarditis (IE) rates have risen sharply, spurred by injection drug use (IDU). Public health interventions to prevent infectious complications of IDU have primarily focused on communicable diseases, such as HIV and viral hepatitis. We assessed patients' knowledge of IE in relation to IDU practice.
From 2021 to 2022, we conducted in-person semi-structured interviews (SSIs) with 16 adults hospitalized with IDU-related IE at an academic medical center in North Carolina. SSIs explored participants' knowledge and experience of IE and IDU practices. The SSIs were audio-recorded, transcribed verbatim, and thematically coded.
We identified 4 primary themes: limited knowledge of IE; nonspecific IE symptoms; injection behavior and infection prevention; and knowledge of other IDU-related infections, such as hepatitis C virus (HCV) and HIV. Most patients reported little or no knowledge of IE before hospitalization despite previously having soft tissue infections, such as skin abscesses. Presentations were heterogeneous, with many patients not recognizing their symptoms as IE, and often delaying seeking care. In contrast to limited information about IE, all patients reported prior testing for HIV and HCV. While many expressed the importance of not reusing injection equipment, many patients reported reusing injection equipment nonetheless, and several specifically reported that they take no dedicated precautions to prevent infections.
Our findings suggest prior to hospitalizations, knowledge of IE, its symptoms, and prevention is limited among persons who inject drugs who acquire IE. Our study indicates an urgent need to disseminate public health messages regarding preventing IDU-related invasive bacterial infections and providing access to sterile equipment to prevent bacterial infections.
在注射吸毒（IDU）的推动下，感染性心内膜炎（IE）的发病率急剧上升。预防IDU感染并发症的公共卫生干预主要集中在传染病方面，如艾滋病毒和病毒性肝炎。我们评估了患者对与IDU行为相关的IE的认知情况。
2021年至2022年期间，我们在北卡罗来纳州的一家学术医疗中心对16名因IDU相关IE住院的成年人进行了面对面的半结构式访谈（SSI）。SSI探讨了参与者对IE和IDU行为的认知及经历。SSI进行了录音，逐字转录，并进行了主题编码。
我们确定了4个主要主题：对IE的了解有限；IE的非特异性症状；注射行为与感染预防；以及对其他IDU相关感染的认知，如丙型肝炎病毒（HCV）和艾滋病毒。大多数患者报告称，尽管之前有过软组织感染，如皮肤脓肿，但在住院前对IE知之甚少或一无所知。症状表现多种多样，许多患者没有意识到自己的症状是IE，往往延迟就医。与关于IE的信息有限形成对比的是，所有患者都报告曾接受过艾滋病毒和HCV检测。虽然许多人表示不重复使用注射设备很重要，但仍有许多患者报告重复使用注射设备，还有几人特别表示他们没有采取专门的预防措施来预防感染。
我们的研究结果表明，在因IDU感染IE的吸毒者中，住院前对IE及其症状和预防的了解有限。我们的研究表明，迫切需要传播有关预防与IDU相关的侵袭性细菌感染以及提供无菌设备以预防细菌感染的公共卫生信息。
