Microbiological contamination in androgens from the black market

TL;DR

Black market androgens can contain bacteria, posing a risk of infection even when unused.

Contribution

This study reveals microbiological contamination in black market androgens, highlighting previously underrecognized health risks.

Findings

Bacterial contamination was found in 9% of used multidose vials and 2% of unused ampules.

Contaminated products contained species like Bacillus spp. and Staphylococcus epidermidis.

No injection-related infections were reported among participants.

Abstract

Androgens from the black market are often produced in clandestine laboratories without adherence to hygienic manufacturing processes. Consequently, users may face an increased risk of developing injection-related infections caused by microbiological contamination. This study aimed to determine the presence of microbiological contamination in androgens from the black market.

Characteristics of submitted androgen product were registered. Androgen products were submitted to aerobic and anaerobic bacterial culture using direct inoculation of agar plates and enrichment using BD BACTEC™ Peds Plus Medium blood culture bottles. Participants who submitted products were monitored for injection-related infections.

Bacterial contamination was detected in two of 22 used multidose vials (9%) and one of 41 unused ampules and multidose vials (2%). Identified species included Bacillus spp., Staphylococcus epidermidis, Staphylococcus warneri, Staphylococcus saprophyticus and Micrococcus luteus. None of the participants developed injection-related infections linked to contaminated products.

Both used and unused androgens from the black market can contain bacteria. This can put users at risk for serious injection-related health problems such as abscesses. This study underlines the importance of warning androgen users about these underrecognized injection-related risks.

Study number: NL77191.028.21. Registration date: 2 June 2021.