Background People who inject drugs (PWID) are at increased risk of community-acquired Staphylococcus aureus bacteraemia (CA-SAB), but little is known about clinical outcomes of CA-SAB in PWID compared with the wider population of patients with CA-SAB. Methods Three national datasets were linked to provide clinical and mortality data on patients hospitalised with CA-SAB in England between 1 January 2017 and 31 December 2020. PWID were identified using the ICD-10 code for “mental health and behavioural disorder due to opioid use” (F11). Multivariable logistic regression was used to estimate adjusted odds ratios (aORs) for associations of PWID with 30-day all-cause mortality and 90-day hospital readmission. Results In 10,045 cases of CA-SAB, 1,612 (16.0%) were PWID. Overall, 796 (7.9%) patients died within 30 days of CA-SAB admission and 1,189 (11.8%) patients were readmitted to hospital within 90 days of CA-SAB. In those without infective endocarditis there was strong evidence of lower odds of mortality among PWID compared with non-PWID (aOR: 0.47, 95% confidence interval, CI: 0.33-0.68, p < 0.001) whereas there was no association in CA-SAB case fatality with endocarditis (aOR 1.40, CI 0.87-2.25, p = 0.163). PWID were less likely to be re-admitted within 90 days of CA-SAB (aOR 0.79, CI 0.65-0.95, p = 0.011). Conclusions In this large cohort study of patients with CA-SAB in England, PWID had lower odds of death in the absence of endocarditis and lower odds of re-admission within 90 days compared to non-PWID patients. This study highlights the over-representation of PWID among patients with CA-SAB nationally.

中文翻译：

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注射吸毒者中社区获得性金黄色葡萄球菌菌血症：2017-2020 年英格兰国家队列研究

背景 注射吸毒者 (PWID) 患社区获得性金黄色葡萄球菌菌血症 (CA-SAB) 的风险较高，但与更广泛的 CA-SAB 患者相比，注射吸毒者 (PWID) 中 CA-SAB 的临床结果知之甚少。方法 将三个国家数据集关联起来，提供 2017 年 1 月 1 日至 2020 年 12 月 31 日期间英格兰因 CA-SAB 住院患者的临床和死亡率数据。使用 ICD-10 代码“因阿片类药物使用导致的心理健康和行为障碍”来识别吸毒者。 ”（F11）。使用多变量逻辑回归来估计吸毒者与 30 天全因死亡率和 90 天再入院之间的关系的调整优势比 (aOR)。结果 10,045 例 CA-SAB 病例中，1,612 例（16.0%）为注射吸毒者。总体而言，796 名患者 (7.9%) 在 CA-SAB 入院后 30 天内死亡，1,189 名患者 (11.8%) 在 CA-SAB 入院后 90 天内重新入院。在没有感染性心内膜炎的患者中，有强有力的证据表明，与非注射吸毒者相比，注射吸毒者的死亡率较低（aOR：0.47，95％置信区间，CI：0.33-0.68，p < 0.001），而与 CA- 之间没有关联。 SAB 心内膜炎病例死亡率（aOR 1.40，CI 0.87-2.25，p = 0.163）。吸毒者在 CA-SAB 后 90 天内再次入院的可能性较小（aOR 0.79，CI 0.65-0.95，p = 0.011）。结论 在这项英国 CA-SAB 患者的大型队列研究中，与非吸毒者相比，吸毒者在没有心内膜炎的情况下死亡的几率较低，并且 90 天内再次入院的几率也较低。这项研究强调了全国 CA-SAB 患者中注射吸毒者的比例过高。