Correlates of Skin and Soft Tissue Infections in Injection Drug Users in a Syringe-Exchange Program in Malmö, Sweden

Subst Use Misuse. 2015;50(12):1529-35. doi: 10.3109/10826084.2015.1023450. Epub 2015 Nov 19.

Abstract

Background: Injection drug users (IDUs) are at increased risk of various medical conditions, including bacterial skin and soft tissue infections (SSTIs). SSTIs, which are painful and can lead to life-threatening complications, are common but scarcely studied.

Objectives: To investigate life time, past 12 month and past 30-day prevalence for SSTI related to injection drug use, in IDUs at Malmö syringe exchange program (Malmö SEP). To investigate factors associated with having ever had an SSTI.

Methods: IDUs were recruited from Malmö SEP (N = 80). They participated in a survey with questions about demographics, drug use, and experience of SSTIs. Factors independently associated with self-reported SSTI ever were assessed using logistic regression analysis.

Results: The lifetime reported prevalence of SSTI was 58%, past 12 months 30%, and past 30 days 14%. Factors independently associated with SSTI ever were age (adjusted odds ratio [AOR] = 1.09; 95% confidence interval [CI] = 1.01-1.18), female sex (AOR = 6.75; 95% CI = 1.40-32.47), having ever injected prescribed drugs (AOR = 52.15; 95% CI = 5.17-525.67), and having ever injected in the neck (AOR = 8.08; 95% CI = 1.16-56.08).

Conclusions/importance: SSTI is common among IDUs in Malmö. Women and those injecting in the neck or injecting prescribed drugs (crushed tablets/liquids), are more likely to have had an SSTI.

Keywords: abscess; injection drug use; risk injection; skin and soft tissue infection; syringe exchange.

MeSH terms

  • Adult
  • Amphetamine-Related Disorders / epidemiology
  • Buprenorphine
  • Buprenorphine, Naloxone Drug Combination
  • Drug Users / statistics & numerical data*
  • Female
  • Heroin Dependence / epidemiology
  • Housing / statistics & numerical data
  • Humans
  • Ill-Housed Persons / statistics & numerical data
  • Logistic Models
  • Male
  • Methadone
  • Methylphenidate
  • Middle Aged
  • Neck
  • Needle-Exchange Programs*
  • Odds Ratio
  • Opioid-Related Disorders / epidemiology
  • Prescription Drugs
  • Prevalence
  • Sex Factors
  • Skin Diseases, Bacterial / epidemiology*
  • Soft Tissue Infections / epidemiology*
  • Substance Abuse, Intravenous / epidemiology*
  • Surveys and Questionnaires
  • Sweden / epidemiology
  • Young Adult

Substances

  • Buprenorphine, Naloxone Drug Combination
  • Prescription Drugs
  • Methylphenidate
  • Buprenorphine
  • Methadone