ArticlePloS one2019
A controlled-release oral opioid supports S. aureus survival in injection drug preparation equipment and may increase bacteremia and endocarditis risk.
Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT04544306 (Partial Oral Antimicrobial Versus Intravenous Antimicrobial Therapy to Treat Infective Endocarditis in People Who Inject Drugs), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Partial Oral Antimicrobial Versus Intravenous Antimicrobial Therapy to Treat Infective Endocarditis in People Who Inject Drugs
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Controlled-release hydromorphone and risk of infection in adults: a systematic review.Harm reduction journal · 2023Pooled it
- Association of skin infections with sharing of injection drug preparation equipment among people who inject drugs.The International journal on drug policy · 2021Trial
- Recent hydromorphone injection and risk of incident infective endocarditis among people who inject drugs in Toronto, Canada: a cohort study.Harm reduction journal · 2026Article
- Community-Acquired Staphylococcus aureus Bacteremia Among People Who Inject Drugs: A National Cohort Study in England, 2017-2020.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Staphylococcus aureus carriage and prevalence of skin and soft tissue infections among people who inject drugs: a longitudinal study.Scientific reports · 2024Article
- Drug preparation, injection-related infections, and harm reduction practices among a national sample of individuals entering treatment for opioid use disorder.Harm reduction journal · 2024Article
- Everything but the Kitchen Sink: An Analysis of Bacterial and Chemical Contaminants Found in Syringe Residue From People Who Inject Drugs.Open forum infectious diseases · 2024Article
- Association of Illicit Fentanyl Use with Injection Risk Practices Among People who Inject Drugs.AIDS and behavior · 2023Article
- Different drugs, different sides: injection use of opioids alone, and not stimulants alone, predisposes to right-sided endocarditis.Open heart · 2022Article
- "I have such a hard time hitting myself, I thought it'd be easier": perspectives of hospitalized patients on injecting drugs into vascular access devices.Harm reduction journal · 2022Article
- Correlates of 90-Day Mortality Among People Who Do and Do Not Inject Drugs With Infective Endocarditis in Seattle, Washington.Open forum infectious diseases · 2022Article
- Hospital admissions and mortality due to complications of injection drug use in two hospitals in Regina, Canada: retrospective chart review.Harm reduction journal · 2021Article
- Article
- Soft Tissue, Bone, and Joint Infections in People Who Inject Drugs.Infectious disease clinics of North America · 2020Review
- Article
- Risk factors of infective endocarditis in persons who inject drugs.Harm reduction journal · 2020Article
- Tackling the overdose crisis: The role of safe supply.The International journal on drug policy · 2020Article
- Recurrent Endocarditis in Persons Who Inject Drugs.Open forum infectious diseases · 2019Article
- Trends in Hospitalizations for Serious Infections Among People With Opioid Use Disorder in Ontario, Canada.Journal of addiction medicineArticle
- Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInjection drug use-associated endocarditis (IDUaIE) incidence in Ontario has recently been associated with hydromorphone prescribing rates. Staphylococcus aureus causes the majority of cases of IDUaIE in Ontario and across North America. Hydromorphone controlled-release (Hydromorphone-CR) requires a complex technique for injection and therefore provides multiple opportunities for contamination. Hydromorphone-CR contains several excipients, which could enhance staphylococcal survival and increase risk of contaminating the injectate.
methodsUsed injection drug preparation equipment (cookers/filters) was collected from persons who inject drugs (PWID), rinsed with water, and plated on Mannitol salt agar. Bacterial isolates from bacteremic PWID were used to assess the survival of S. aureus and Streptococcus pyogenes on cookers/filters with Hydromorphone-CR, hydromorphone immediate-release (Hydromorphone-IR) or oxycodone controlled-release (Oxycodone-CR). The solutions spiked with S. aureus were heated and the remaining viable bacteria enumerated.
resultsS. aureus was detected in 12/87 (14%, 95%CI 8-23%) cookers/filters samples used for injection of Hydromorphone-CR. Hydromorphone-CR was the only opioid associated with greater survival of methicillin-sensitive S. aureus (MSSA) and methicillin-resistant S. aureus (MRSA) on cookers/filters when compared to sterile water vehicle control. There was a ~2 log reduction in the number of S. aureus that survived when cookers/filters were heated.
conclusion14% of all cookers/filters used in the preparation of Hydromorphone-CR were contaminated with S. aureus. Hydromorphone-CR prolongs the survival of MRSA and MSSA in cookers/filters. Heating cookers/filters may be a harm-reduction strategy.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.