Risk Factors Associated With Skin and Soft Tissue Infections Among Hospitalized People Who Inject Drugs

Objectives:Skin and soft tissue infections (SSTIs) are common among people who inject drugs (PWID), and can lead to serious morbidity and costly emergency room and hospital utilization. A range of high-risk injection practices may contribute to these infections. The goal of the current study was to examine risk practices that were associated with SSTIs in a sample of hospitalized PWID.Methods:PWID (N=143; 40.6% female) were recruited from inpatient medical units at a large urban hospital and completed a baseline interview that focused on infection risk. Measures included demographics, substances used/injected, and self-report of SSTIs (ie, abscesses, ulcers, or cellulitis) within the past year. The Bacterial Infections Risk Scale for Injectorsa 7-item indexassessed specific behaviors expected to increase the risk of acquiring SSTIs (eg, injection without skin cleaning, intramuscular injection).Results:The sample was 58% Caucasian and averaged 38.7 (SD=10.7) years of age. Ninety-three participants (65%) reported at least 1 SSTI within the past year. Using a logistic regression model, the Bacterial Infections Risk Scale for Injectors (odds ratio 1.87, P=0.004) and total number of injections over the past 3 months (odds ratio 2.21, P=0.002) were associated with past year SSTIs.Conclusions:In conclusion, rates of past-year SSTIs were high in this sample of hospitalized PWID. Results suggest that interventions should target specific injection practices to reduce infection risk.