Ms Beth Bint1, Mrs Joanna Harris1
1Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
The increased risk of bacteraemia and associated serious complications culminating in poor morbidity and mortality outcomes among injecting drug users (IDU), is well known. Studies have indicated that infection prevention intervention strategies may reduce the risk of bacteraemias in the IDU population. With an estimated 1400 to 2400 IDU within the LHD, we sought to determine the incidence of Staphylococcus aureus bacteraemias (SAB) in this population and use these findings to inform the potential benefit of harm reduction strategies.
The LHD Infection Management and Control Service has an established database of all SABs reported by the in-house microbiology department. The dataset includes the primary and secondary sources of the SAB and associated morbidity and mortality. This database was interrogated to identify community-associated SAB (CA-SAB) reviewed between January 2009 and December 2017 to identify the number of IDU associated cases and compare with data relating to people not identified as IDU.
The number of cases identified represented an estimated annual CA-SAB rate within this population of 3%, compared to the estimated rate among the assumed non-IDU population of 0.2%. The rate of serious complications in the IDU group including: epidural abscess, endocarditis and cerebral emboli was near 50%.
This review confirms an increased SAB incidence and serious complication rates within the local IDU population. These findings indicate that there is an ethical imperative to identify culturally appropriate and effective intervention strategies to address this significant risk in this vulnerable population group.
Beth Bint is an Infection Prevention and Control (IPC) Clinical Nurse Consultant (CNC) working in the Illawarra Shoalhaven Local Health District. Beth has been working in the field of infection prevention and control for over 25 years commencing in the Hunter New England Health Service in 1992 before moving to South Australia in 2006, working as an infection control project officer for Pandemic Influenza Planning for SA Health. In 2009 Beth returned to NSW to take up the positon of a CNC in the Illawarra Shoalhaven Local Health District. Beth has had the privilege of contributing to the development of State and National infection prevention control policies, guidelines and education resources. With a broad experience across a wide variety of healthcare settings, Beth remains passionate about IPC and all its challenges living by the mantra of Albert Einstein “The important thing is to never stop questioning”