Skin and Soft Tissue Infections in Persons Who Inject Drugs

Infect Dis Clin North Am. 2021 Mar;35(1):169-181. doi: 10.1016/j.idc.2020.10.006. Epub 2020 Dec 7.

Abstract

Persons who inject drugs are at high risk for skin and soft tissue infections. Infections range from simple abscesses and uncomplicated cellulitis to life-threatening and limb-threatening infections. These infections are predominantly caused by gram-positive organisms with Staphylococcus aureus, Streptococcus pyogenes, and other streptococcal species being most common. Although antimicrobial therapy has an important role in treatment of these infections, surgical incision, drainage, and debridement of devitalized tissue are primary. Strategies that decrease the frequency of injection drug use, needle sharing, use of contaminated equipment, and other risk behaviors may be effective in preventing these infections in persons who inject drugs.

Keywords: Cellulitis; Clostridium perfringens; Clostridium sordellii; Cutaneous abscess; Injection drug use; Necrotizing fasciitis; Staphylococcus aureus; Streptococcus pyogenes.

Publication types

  • Review

MeSH terms

  • Abscess / epidemiology
  • Anti-Bacterial Agents / therapeutic use
  • Cellulitis / epidemiology
  • Clostridium perfringens / isolation & purification
  • Clostridium sordellii / isolation & purification
  • Debridement / methods
  • Drainage / methods
  • Drug Users
  • Fasciitis, Necrotizing / epidemiology
  • Gram-Positive Bacterial Infections / epidemiology
  • Humans
  • Pyomyositis / epidemiology
  • Skin Diseases, Infectious / epidemiology*
  • Skin Diseases, Infectious / microbiology
  • Skin Diseases, Infectious / therapy
  • Soft Tissue Infections / epidemiology*
  • Soft Tissue Infections / microbiology
  • Soft Tissue Infections / therapy
  • Staphylococcus aureus / isolation & purification
  • Streptococcus pyogenes / isolation & purification
  • Substance Abuse, Intravenous / epidemiology*
  • Substance Abuse, Intravenous / microbiology

Substances

  • Anti-Bacterial Agents