[Infectious diseases in problem drug users hospitalized in the infectious ward of the Motol University Hospital in 2002-2005].
BACKGROUND
To survey infectious diseases in intravenous drug users and to provide basic information on disease course in this subpopulation.


METHODS
A retrospective study of all inpatient intravenous drug users, from 2002 to 2005. The obtained data were sorted according to the main diagnosis and final results of chronic infections were achieved by outpatient follow-up.


RESULTS
Out of 436 cases of intravenous drug users in our group, 44 % (191/436) were patients admitted with acute viral hepatitis, 16 % (67/436) with soft-tissue or skin infections, 7 % (29/436) with respiratory infections, 4 % (18/436) with urogenital infections and 4 % (19/436) with sepsis. Progression to chronic hepatitis B occurred in 3 % (4/125) of cases, fulminant course of acute hepatitis B was observed in 1.6 % (2/125) of cases. Spontaneous clearance of hepatitis C virus was demonstrated in 46 % (11/24) of subjects. The most frequent pathogens responsible for bacterial infections in drug users were Staphylococcus aureus (53 %, 27/51) and Streptococcus pyogenes (22 %, 11/51). In the infectious endocarditis group, right heart valves were affected in 78 % (7/9), left heart valves in 11 % (1/9) and bilateral lesions were seen in 11 % (1/9) of cases. Two (22 %, 2/9) endocarditis patients died (one with tricuspid and the other with aortic valve involvement). Patients with the main diagnosis other than hepatitis were screened and 71 % of them were found positive for anti-HCV, 57 % for anti-HBc total and 32 % for anti-HAV total.


CONCLUSIONS
During the analyzed period, no HIV-positive drug users were found. The findings are in striking contrast to data published abroad. Treatment of drug users is often complicated by low compliance with the treatment and hospital regimens and/or by a frequent lack of follow-up treatment. Despite this fact, no significant variations in the course or results of infectious diseases in drug users were found in comparison to the general population.
Vitous
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Department of Infectious Diseases, University Hospital Motol, V Uvalu 84, 150 06 Prague 5, Czech Republic. adavity@volny.cz
Hobstová
J
J
D000208:Acute Disease; D000328:Adult; D003141:Communicable Diseases / Q000150:complications* / Q000382:microbiology; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007297:Inpatients; D008297:Male; D015819:Substance Abuse, Intravenous / Q000150:complications*