Reemergence of Intravenous Drug Use as Risk Factor for Candidemia, Massachusetts, USA
Ellison, Richard T. III
Levitz, Stuart M.
UMass Chan AffiliationsDepartment of Medicine, Division of Infectious Diseases and Immunology
intravenous substance abuse
Bacterial Infections and Mycoses
Immunology and Infectious Disease
Substance Abuse and Addiction
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AbstractThe epidemic of illicit intravenous drug use (IVDU) in the United States has been accompanied by a surge in drug overdose deaths and infectious sequelae. Candida albicans infections were associated with injection of contaminated impure brown heroin in the 1970s-1990s; however, candidiasis accompanying IVDU became considerably rarer as the purity of the heroin supply increased. We reviewed cases of candidemia occurring over a recent 7-year period in persons > 14 years of age at a tertiary care hospital in central Massachusetts. Of the 198 patients with candidemia, 24 cases occurred in patients with a history of IVDU. Compared with non-IVDU patients, those with a history of IVDU were more likely to have non-albicans Candida, be co-infected with hepatitis C, and have end-organ involvement, including endocarditis and osteomyelitis. Thus, IVDU appears to be reemerging as a risk factor for invasive candidiasis.
Poowanawittayakom N, Dutta A, Stock S, Touray S, Ellison RT 3rd, Levitz SM. Reemergence of Intravenous Drug Use as Risk Factor for Candidemia, Massachusetts, USA. Emerg Infect Dis. 2018 Apr;24(4):631–7. doi: 10.3201/eid2404.171807. PMID: 29553923; PMCID: PMC5875264. Link to article on publisher's site