Skip to main content Accessibility help
×
Home

Staphylococcus aureus bacteraemia associated with injected new psychoactive substances

  • D. J. GRIFFITH (a1), C. L. MACKINTOSH (a1) and D. INVERARITY (a2)

Summary

Injecting drug use is often associated with deep-seated infection. In Lothian in Scotland there has been a recent increase in the use of injected new psychoactive substances (NPS). Patients who have injected NPS have presented with Staphylococcus aureus bacteraemia (SAB) with life-threatening complications. We describe a unique case-series of 14 episodes of SAB in ten patients. Users of injected NPS had a significantly higher incidence of endocarditis and cavitating pulmonary lesions (P < 0·05) compared to those who inject only opiates. Cases of SAB in people who inject NPS have contributed to a significant rise in the overall incidence of SAB in people who inject drugs (P < 0·05) which has in turn impacted on the ability of Lothian to meet national targets for reducing the incidence of SAB.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Staphylococcus aureus bacteraemia associated with injected new psychoactive substances
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Staphylococcus aureus bacteraemia associated with injected new psychoactive substances
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Staphylococcus aureus bacteraemia associated with injected new psychoactive substances
      Available formats
      ×

Copyright

Corresponding author

*Author for correspondence: Dr D. J. Griffith, Regional Infectious Diseases Unit, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, UK. (Email: davidgriffith2@nhs.net)

References

Hide All
1. Scottish Government: Drug-related deaths in Scotland in 2013. (http://www.nrscotland.gov.uk/files//statistics/drug-related-deaths/2013/drugs-related-deaths-2013.pdf). Accessed 9 June 2015.
2. Aoun, EG, Christopher, PP, Ingraham, JW. Emerging drugs of abuse: clinical and legal considerations. Rhode Island Medical Journal 2014; 97: 4145.
3. Baumann, MH, et al. Bath salts, spice and related designer drugs: the science behind the headlines. Journal of Neuroscience 2014; 34: 1515015168.
4. Johnson, PS, Johnson, MW. Investigation of ‘bath salts’ use patterns within an online sample of users in the United States. Journal of Psychoactive Drugs 2014; 46: 369378.
5. Scottish Drugs Forum: NPS in Scotland – Health Impacts. (http://www.sdf.org.uk/resources/reports-and-research/#3). Accessed 9 June 2015.
6. Scotland's Census 2011. (http://www.scotlandscensus.gov.uk/). Accessed 9 June 2015.
7. Schneir, A, et al. Comprehensive analysis of ‘bath salts’ purchased from California stores and the internet. Clinical Toxicology (Philadelphia) 2014; 52: 651658.
8. Scottish Drugs Forum Information Sheet. MPA (Methiopropamine) (www.sdf.org.uk/index.php/download_file/view/670/106/). Accessed 9 June 2015.
9. Araujo, AM, et al. Raising awareness of new psychoactive substances: chemical analysis and in vitro toxicity screening of ‘legal high’ packages containing synthetic cathinones. Archives of Toxicology 2015; 89: 757–711.
10. Iversen, L, et al. Neurochemical profiles of some novel psychoactive substances. European Journal of Pharmacology 2013; 700: 147–51.
11. Belton, P, et al. Cardiac infection and sepsis in 3 intravenous bath salts drug users. Clinical Infectious Diseases 2013; 56: e102-e104.
12. Banks, ML, et al. Synthetic cathinones (‘bath salts’). Journal of Emergency Medicine 2014; 46: 632642.
13. Hohmann, N, Mikus, G, Czock, D. Effects and risks associated with novel psychoactive substances: mislabelling and sale as bath salts, spice and research chemicals. Deutsches Arzteblatt International 2014; 111: 139147.
14. Martinez-Clemente, J, et al. Dose and time-dependent selective neurotoxicity induced by mephedrone in mice. PLoS ONE 2014; 9: e99002.
15. Dorairaj, JJ, et al. The untold truth about ‘bath salt’ highs: a case series demonstrating local tissue injury. Journal of Plastic, Reconstructive and Aesthetic Surgery 2012; 65: e37e41.
16. Russo, R, et al. Life-threatening necrotizing fasciitis due to ‘bath salts’ injection. Orthopedics 2012; 35: e124127.
17. Thwaites, GE, et al. Clinical management of Staphylococcus aureus bacteraemia. Lancet Infectious Diseases 2011; 11: 208222.
18. van Hal, SJ, et al. Predictors of mortality in Staphylococcus aureus bacteraemia. Clinical Microbiology Reviews 2012; 25: 362386.
19. Kobayashi, D, et al. A predictive rule for mortality of inpatients with Staphylococcus aureus bacteraemia: a classification and regression tree analysis. European Journal of Internal Medicine 2014, 25: 914918.
20. Fortuin-de Smidt, MC, et al. Staphylococcus aureus bacteraemia in Gauteng academic hospitals, South Africa. International Journal of Infectious Diseases 2014; 30:4148.
21. Jensen, AG, et al. Treatment and outcome of Staphylococcus aureus bacteraemia: a prospective study of 278 cases. Archives of Internal Medicine 2002; 162: 2532.
22. Ye, R, et al. Clinical characteristics of septic pulmonary embolism in adults. Respiratory Medicine 2014; 108: 18.
23. Healthcare Improvement Scotland. Guidance on management of proven or suspected Staphylococcus aureus bacteraemia in adults (January 2013) (https://www.scottishmedicines.org.uk/files/sapg1/SAB_algorithm__greyscale_.pdf). Accessed 9 June 2015.
24. Holland, TL, Arnold, C, Fowler, VG. Jr. Clinical management of Staphylococcus aureus bacteraemia: a review. Journal of the American Medical Association 2014; 312: 13301341.
25. Lopez-Cortes, LE, et al. Impact of an evidence-based bundle intervention in the quality-of-care management and outcome of Staphylococcus aureus infection. Clinical Infectious Diseases 2013; 57: 12251233.
26. Gould, FK, et al. Guidelines (2008) for the prophylaxis and treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections in the United Kingdom. Journal of Antimicrobial Chemotherapy 2009; 63: 849861.
27. Health Protection Scotland. Weekly report (13 January 2015) including commentary on quarterly epidemiological data on Staphylococcus aureus (S. aureus) bacteraemia infection in Scotland, July to September (Q3) 2014 (http://www.hps.scot.nhs.uk/documents/ewr/pdf2015/1502.pdf). Accessed 9 June 2015.
28. Scottish Government HEAT targets for NHS Scotland. (http://www.scotland.gov.uk/About/Performance/scotPerforms/partnerstories/NHSScotlandperformance/SAB). Accessed 9 June 2015.
29. Harmsen, D, et al. Typing of methicillin-resistant Staphylococcus aureus in a university hospital setting by using novel software for spa repeat determination and database management. Journal of Clinical Microbiology 2003; 41: 54425448.
30. Lina, G, et al. Involvement of Panton-Valentine leukocidin-producing Staphylococcus aureus in primary skin infections and pneumonia. Clinical Infectious Diseases 1999; 29: 11281132.
31. Brett, MM, et al. Soft tissue infections caused by spore-forming bacteria in injecting drug users in the United Kingdom. Epidemiology and Infection 2005; 133: 575582.
32. Grundmann, H, et al. The dynamic changes of dominant clones of Staphylococcus aureus causing bloodstream infections in the European region: results of a second structured survey. Eurosurveillance 2014; 19: pii 20987.
33. Bassetti, S, Battegay, M. Staphylococcus aureus infections in injection drug users: risk factors and prevention strategies. Infection 2004; 32: 163169.

Keywords

Staphylococcus aureus bacteraemia associated with injected new psychoactive substances

  • D. J. GRIFFITH (a1), C. L. MACKINTOSH (a1) and D. INVERARITY (a2)

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed