# Clinical Spectrum of Infections Among People Who Inject Drugs, With Special Reference to Infective Endocarditis

## TL;DR

This study explores infections among people who inject drugs, focusing on the high occurrence of infective endocarditis and skin infections.

## Contribution

The study highlights the clinical spectrum of infections in young people who inject drugs, emphasizing infective endocarditis and its association with skin infections and hepatitis C.

## Key findings

- Young adults, predominantly males, are increasingly represented among people who inject drugs.
- Skin and soft tissue infections are the most common injection-related infections among PWID.
- Infective endocarditis accounts for 18% of infections among PWID and is linked to hepatitis C.

## Abstract

Background

Injection drug use (IDU) is a significant public health concern worldwide and is frequently associated with serious health complications, including infectious diseases. Among these, infective endocarditis (IE) stands out as a particularly concerning infection, posing a significant threat to people who inject drugs (PWID). This study examines the clinical spectrum of infections, with a specific focus on IE among PWID.

Methods

This was a hospital-based cross-sectional study conducted over a period of one year to assess subjects comprising PWID. Study participants were recruited from both the inpatient and OPDs of GMCH. Data were collected using a predesigned proforma, and analysis was performed using IBM SPSS Statistics for Windows, Version 25.0 (Released 2017; IBM Corp., Armonk, NY, USA).

Results

Our findings indicate that young adults are increasingly represented among PWID, with a mean age of 25.94 years and a predominance of males. Analysis of substances used by PWID highlights heroin as the predominant drug. The study reports a high prevalence of psychiatric comorbidities and concomitant hepatitis C infection among PWID. Overall, skin and soft tissue infections (SSTIs; 36%) emerged as the most commonly acquired injection-related infection among PWID, and IE comprised 18% of the presenting infections.

Conclusions

The high frequency of IE among patients with SSTIs and hepatitis C virus highlights the critical need for improved screening using blood cultures and echocardiography in young PWID. Targeted interventions are necessary to enhance the diagnosis and management of IE, which could slow the progression from SSTIs to IE and reduce associated mortality and morbidity. Ultimately, these findings improve our understanding of the clinical spectrum of infections among PWID.