heroin and Staphylococcal-Infections

Topics: Anemia, Sickle Cell; Cryoglobulinemia; Endothelium; Glomerulonephritis; Hemolytic-Uremic Syndrome; Hepatitis B; Heroin; Humans; Kidney; Kidney Transplantation; Leukemia; Lupus Erythematosus, Systemic; Malaria; Schistosomiasis; Staphylococcal Infections; Vascular Surgical Procedures

Topics: Analgesics, Opioid; Communicable Diseases; Drug Users; Fentanyl; Hepatitis; Heroin; HIV Infections; Humans; Opioid-Related Disorders; Staphylococcal Infections; Staphylococcus aureus; United States

Topics: Anti-Bacterial Agents; Cross Infection; Disease Notification; Heroin; Humans; Infection Control; Male; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Quality of Health Care; Staphylococcal Infections; Substance Abuse, Intravenous; Trimethoprim, Sulfamethoxazole Drug Combination

Injection drug users (IDUs) develop more right-sided infective endocarditis (IE) than non-IDUs, but it is not known whether this risk is specific to any particular injected drug. This study reviews the clinical characteristics of IE in an urban population and examines the association of drug type with manifestations of IE.. A retrospective cohort of 247 cases of IE was analyzed. Demographic, clinical, microbiologic, and echocardiographic data were collected.. Our cohort featured a 74% IDU rate, most with heroin. Staphylococcus aureus was the most prevalent organism. S. aureus IE was more likely to occur in IDUs versus non-IDUs (OR 5.5, p<0.0001). Enterococcus faecalis IE was less likely to occur in IDUs (OR 0.21, p=0.02). Tricuspid valve (TV) IE was more likely to occur in IDUs (OR 4.37, p=0.001), while mitral valve (MV) IE occurred less commonly in IDUs (OR 0.40, p=0.005). TV IE occurred more frequently in heroin users vs. IDUs not using heroin (OR 4.03, p=0.033).. The epidemiology of IE in this cohort is different from that reported recently in other cohorts, likely due to the high prevalence of IDU. Heroin use may underlie the association between IDU and right-sided endocarditis.

Topics: Endocarditis; Endocarditis, Bacterial; Female; Heart Valve Diseases; Heroin; Hospitals, Urban; Humans; Male; Retrospective Studies; Staphylococcal Infections; Staphylococcus aureus; Substance Abuse, Intravenous

The medical care of injecting drug misusers presents many challenges. Though they can be awkward and unreliable they are at risk of serious medical conditions not often seen in the general population. This case report illustrates some of the difficulties in the diagnosis and treatment of a patient with pyomyositis associated with heroin injection.

Topics: Adult; Heroin; Humans; Male; Myositis; Staphylococcal Infections; Substance Abuse, Intravenous; Suppuration; Tomography, X-Ray Computed

Topics: Adult; Diagnostic Imaging; Disease Susceptibility; Heroin; HIV Infections; Humans; Male; Myositis; Staphylococcal Infections; Substance Abuse, Intravenous; Suppuration

The authors describe three patients in whom septic arthritis of the sternoclavicular joint (SCJ) occurred, drug addiction and human immunodeficiency virus (HIV) infection representing the predisposing conditions. Infectious arthritis is well known in intravenous drug users, but it is rare in HIV positive patients, who are prone to bacterial infections from usual or unusual microorganisms. In one case, staphylococcus aureus methicillin sensitive was responsible for septic arthritis. In another case, SCJ infection was associated with pneumonitis.

Topics: Adult; Arthritis, Infectious; Heroin; HIV Seropositivity; Humans; Male; Staphylococcal Infections; Sternoclavicular Joint; Substance-Related Disorders; Tomography, X-Ray Computed

We report a successful transplantation of a human tricuspid valve in a human. We used a fresh tricuspid homograft with its chordae tendineae and papillary muscles, harvested 5 days earlier under sterile conditions from a multiorgan donor a few minutes after cardiectomy (the heart was not suitable for cardiac transplantation) and immediately stored at 4 degrees C. We elected to implant the homograft in a young heroin addict. Our experience demonstrates that the implantation of an atrioventricular homograft in the orthotopic position is technically feasible and can achieve good results, at least in the short term.

Topics: Adolescent; Endocarditis; Heroin; Humans; Male; Staphylococcal Infections; Substance-Related Disorders; Transplantation, Homologous; Tricuspid Valve; Tricuspid Valve Insufficiency

Topics: Adult; Cocaine; Emergencies; Female; Heroin; Humans; Joint Prosthesis; Masseter Muscle; Prosthesis-Related Infections; Staphylococcal Infections; Substance Abuse, Intravenous; Temporomandibular Joint

Topics: Bacterial Infections; Bacteroides Infections; Endocarditis, Bacterial; Fusobacterium Infections; Heroin; Humans; Male; Middle Aged; Staphylococcal Infections; Streptococcal Infections; Substance-Related Disorders; Veillonella

A patient with methicillin-resistant Staphylococcus aureus bacteremia received vancomycin (MIC = 0.8 microgram/ml, MBC = 15 micrograms/ml) and heparin simultaneously through the same intravenous line to treat a septic deep venous thrombosis. Bacteremia persisted for 7 days. Bacteremia terminated when the simultaneous infusion of heparin and vancomycin through the same line was stopped. This suggested that an interaction between vancomycin and heparin may have occurred, which resulted in a reduction in vancomycin activity. To test for such an interaction, mixtures of heparin and vancomycin in various concentrations were made and tested for antimicrobial activity against the organisms in the patient. A precipitate formed at the concentrations achieved in the intravenous lines, and when the vancomycin concentrations were measured by bioassay, a 50 to 60% reduction in activity was noted. In contrast, when these solutions were prepared and mixed at microgram concentrations, a precipitate was no longer observed, and antimicrobial activity was not reduced. Heparin appeared to interact unfavorably with vancomycin at the concentrations in the intravenous lines when these drugs were administered simultaneously to patients. This may be the cause of poor therapeutic responses to vancomycin in some patients, especially those infected with tolerant organisms.

Topics: Adult; Drug Combinations; Heparin; Heroin; Humans; Infusions, Parenteral; Male; Sepsis; Staphylococcal Infections; Staphylococcus aureus; Substance-Related Disorders; Thrombophlebitis; Vancomycin

Topics: Endocarditis, Bacterial; Heroin; Humans; Injections, Intravenous; Staphylococcal Infections

We studied antibiotic intake in 197 abusers of alcohol, sedatives, or parenteral heroin or cocaine. Thirteen patients, all abusers of parenteral heroin or cocaine, had taken antibiotics without prescription, obtained from friends, from old prescriptions, or by purchase on the street. Past or present street purchase of antibiotics was noted in 27 patients and was more common (P less than .02) in parenteral substance abusers. Four parenteral substance abusers had infection or colonization with methicillin-resistant Staphylococcus aureus, and three of them had purchased antibiotics on the street before the present or a recent past hospitalization. Physicians treating abusers of parenteral heroin or cocaine should be aware that such patients may be taking antibiotics without medical supervision. This practice may be an important factor in the development and spread of methicillin-resistant S aureus.

Topics: Anti-Bacterial Agents; Cocaine; Drug Resistance, Microbial; Heroin; Humans; Illicit Drugs; Injections, Intravenous; Nonprescription Drugs; Self Medication; Skin Ulcer; Staphylococcal Infections; Substance-Related Disorders; Surveys and Questionnaires

The authors report on 20 cases of bacterial endocarditis in heroin addicts, i.e. 9.1% of all cases of that infection observed over an 8-year period. The disease involved the tricuspid valve in 80% of the cases and was due to Staphylococcus aureus in the same percentage of patients. Diagnosis was sometimes difficult in the right heart but was confirmed by repeated echocardiography. Combined antibiotic therapy was administered for 45 days. Only one patient died of relapsing endocarditis on valve prosthesis. Six patients were operated upon: 2 for cardiac failure, 2 for persistent infection and 2 for recurrent pulmonary embolism. Three patients underwent valve replacement and 3 tricuspidectomy. The persistence of pulmonary embolism after eradication of the infecting organism does not seem to warrant surgery.

Topics: Adult; Echocardiography; Endocarditis, Bacterial; Female; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Male; Recurrence; Staphylococcal Infections; Tricuspid Valve

The authors report the case of a patient with spinal abscess in whom operation was withheld because of severe concomitant medical problems. Conservative management resulted in apparent cure.

Topics: Abscess; Anti-Bacterial Agents; Cefazolin; Cocaine; Duodenal Ulcer; Heroin; Humans; Kidney Failure, Chronic; Male; Meninges; Methicillin; Middle Aged; Myelography; Oxacillin; Renal Dialysis; Spinal Cord Diseases; Staphylococcal Infections; Staphylococcus aureus; Subdural Space; Substance-Related Disorders

Topics: Aspergillus; Bacillus; Bacteria; Clostridium perfringens; Drug Contamination; Endocarditis, Bacterial; Escherichia coli; Heroin; Heroin Dependence; Humans; Injections; Needles; Staphylococcal Infections; Staphylococcus; Syringes

The diagnosis of pyogenic vertebral osteomyelitis was made in seven narcotic addicts between 1967 and 1972. Vertebrae involved were either cervical or lumbar. Bacteriologic diagnosis was made in each case by percutaneous needle biopsy and aspiration. Staphylococcus aureus was cultured in two patients. Five patients had infections due to Gram-negative bacteria, including Klebsiella pneumoniae, Pseudomonas aeruginosa and Enterobacter. All patients were cured by treatment with antibiotics and immobilization.

Topics: Adolescent; Adult; Bacteria; Bacterial Infections; Biopsy, Needle; California; Cervical Vertebrae; Female; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Klebsiella pneumoniae; Lumbar Vertebrae; Male; Osteomyelitis; Pseudomonas aeruginosa; Radiography; Staphylococcal Infections; Substance-Related Disorders

Topics: Adult; Coma; Endocarditis, Bacterial; Heroin; Heroin Dependence; Humans; Jaundice; Male; Sepsis; Staphylococcal Infections; Substance-Related Disorders

Topics: Acute Kidney Injury; Adolescent; Adult; Aged; Anti-Bacterial Agents; Endocarditis, Bacterial; Enterobacteriaceae Infections; Female; Gastrointestinal Hemorrhage; Hemiplegia; Heroin; Heroin Dependence; Humans; Male; Middle Aged; Prospective Studies; Pseudomonas Infections; Pulmonary Embolism; Respiratory Insufficiency; Splenomegaly; Staphylococcal Infections; Streptococcal Infections; Substance-Related Disorders

Topics: Adult; Candida; Candidiasis; Endocarditis, Bacterial; Female; Haemophilus Infections; Haemophilus influenzae; Heart Failure; Heroin; Heroin Dependence; Humans; Male; Neurologic Manifestations; Panophthalmitis; Skin Manifestations; Splenomegaly; Staphylococcal Infections; Staphylococcus; Streptococcal Infections; Streptococcus; Substance-Related Disorders

Topics: Endocarditis, Bacterial; Heroin; Humans; Infections; Osteomyelitis; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcal Infections; Substance-Related Disorders

Topics: Adult; Ampicillin; Diagnosis, Differential; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Male; Penile Diseases; Skin Ulcer; Staphylococcal Infections; Substance-Related Disorders

Topics: Animals; Cardiac Catheterization; Digoxin; Dogs; Heart Failure; Heart Valve Diseases; Heart Valve Prosthesis; Heroin; Humans; Injections, Intravenous; Male; Postoperative Complications; Pseudomonas Infections; Self Medication; Staphylococcal Infections; Substance-Related Disorders; Tricuspid Valve; Tricuspid Valve Insufficiency; Venous Pressure

Topics: Adult; Endocarditis, Bacterial; Heroin; Humans; Injections; Male; Staphylococcal Infections; Substance-Related Disorders; Tricuspid Valve

Topics: Adolescent; Adult; Arthritis, Infectious; Candidiasis; Chronic Disease; Female; Hepatitis; Heroin; Humans; Male; Osteomyelitis; Pseudomonas aeruginosa; Pseudomonas Infections; Sepsis; Spondylitis; Staphylococcal Infections; Substance-Related Disorders

Topics: Abscess; Adult; Autopsy; Diagnosis, Differential; Disseminated Intravascular Coagulation; Endocarditis, Bacterial; Heroin; Humans; Infarction; Kidney Diseases; Lung Abscess; Male; Myocardium; Pleural Effusion; Pulmonary Embolism; Splenic Diseases; Splenic Infarction; Staphylococcal Infections; Staphylococcus; Substance-Related Disorders; Tricuspid Valve

Topics: Endocarditis, Bacterial; Heroin; Humans; Sepsis; Staphylococcal Infections; Substance-Related Disorders

Topics: Adult; Anti-Bacterial Agents; Bacteroides; Bacteroides Infections; Endocarditis, Bacterial; Escherichia coli Infections; Heroin; Humans; Injections, Intravenous; Male; Pulmonary Embolism; Staphylococcal Infections; Streptococcal Infections; Substance-Related Disorders

Topics: Adult; Candidiasis; Endocarditis; Heroin; Humans; Injections, Intravenous; Male; Morphine Dependence; Pseudomonas Infections; Pulmonary Embolism; Staphylococcal Infections; Sterilization; Tricuspid Valve

Topics: Adult; Angiography; Electrocardiography; Endocarditis, Bacterial; Female; Heroin; Humans; Male; Phonocardiography; Pulmonary Valve Insufficiency; Staphylococcal Infections; Substance-Related Disorders

Topics: Abscess; Arthritis; Arthritis, Infectious; Bacteroides; Benzoates; Brain Abscess; Camphor; Cellulitis; Endocarditis; Endocarditis, Bacterial; Endocarditis, Subacute Bacterial; Hepatitis; Hepatitis B virus; Heroin; Humans; Infections; Meningitis; Methicillin; Opium; Penicillin G; Pneumothorax; Sepsis; Staphylococcal Infections; Substance-Related Disorders; Toxicology

Topics: Endocarditis; Endocarditis, Bacterial; Heroin; Humans; Staphylococcal Infections; Substance-Related Disorders