Staphylococcus aureus bloodstream infections (SAB) in the intravenous drug user (IVDU): a retrospective review of Western Australian (WA) surveillance data.

Ms Simone Tempone1, Ms Michelle Stirling1, Ms Rebecca McCann1

1Department Of Health, East Perth, Australia


Even with the declining incidence of infections attributable to healthcare associated (HA) factors, SAB continues to represent a significant burden to the WA healthcare system. This continuing burden has been significantly influenced by the rising incidence of community associated (CA) SAB over the past decade. Work is needed to better understand patient factors in this population so appropriate public health interventions can be effectively targeted.


To investigate patterns of intravenous drug use (IVDU) in patients presenting to Western Australian Public hospitals with Staphylococcus aureus bloodstream infections (SAB).


Retrospective review of routinely collected health data for the Healthcare Infection Surveillance WA (HISWA) SAB surveillance program, of the years 2016-2018.

HISWA SAB surveillance data was extracted for the period 2016-2018. Data included patient demographics (age, gender, postcode), co-morbidities (IVDU), hospital admission details (LOS, discharge type, clinical findings), and SAB pathology details. All cases were classified utilising a standardised case definition.


In total, 1,653 SABs that met the case definition were investigated over the 3 years. 16% had record IVDU (past or active) with 96% of these classified as CA. IVDU associated cases were more likely to discharge against medical advice (p<0.001), more likely to represent with a subsequent SAB (p> 0.01), and had a 30 day all-cause mortality of 8%.


This preliminary investigation highlights a vulnerable patient group that would benefit from a targeted public health intervention that aims to improve their health outcomes by increasing their awareness about safe injecting practices.



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