Med. Pro Praxi 2010; 7(10): 368-371

Drug abuse and infectious diseases

MUDr. Jiřina Hobstová, CSc.

Infekční centrum pro drogově závislé FN Motol, Praha

III. klinika infekčních a tropických nemocí 1. LF UK a FN Na Bulovce, Praha

Seventy percent of long-term drug users use an intravenous route for taking their drug (IDUs). This access carries the highest risk of acquiring

infections, either blood-borne or bacterial ones. The most frequent blood-borne infections are viral hepatitis B (VHB), viral hepatitis

C (VHC) and HIV infection. Nearly one third of IDUs with a five-year drug career had already experienced VHB and VHC. Since the general

vaccination against VHB in 2001, the incidence of VHB has been slowly decreasing. In the year 2008, 307 cases of hepatitis B were reported

and 134 of them had a history of risk behavior and a half of them were IDUs. The incidence of VHC has been stable in the past few years.

From 981 of all reported cases of VHC, 571 (71 %) patients had a history of risk behavior and 540 (66 %) of them were IDUs. The incidence

of HIV infections in IDUs in the Czech Republic is permanently low, up to the end of the year 2008 only 8 % of all 1,189 HIV positive. Except

for the blood-borne infections which are most commonly encountered, IDUs are also frequently at risk of bacterial infections of skin

and soft tissues. The incidence of invasive infections such as sepsis and infectious endocarditis is increasing worldwide. Staphylococcus

aureus or Streptococcus pyogenes group A are usually isolated as the etiological agents of skin and soft tissue infections as well as of the

invasive diseases. The sensitivity of both the bacteria is good. The author’s own experience with the treatment of IDUs is described, and

screening for and vaccination against hepatitis B is recommended. The priority of drug abuse management is strictly stressed.

Keywords: intravenous drug user, viral hepatitis B, viral hepatitis C, bacterial infections, infectious endocarditis, Staphylococcus aureus, Streptococcus pyogenes.

Published: November 1, 2010  Show citation