Confirmed Bacillus anthracis infection among persons who inject drugs, Scotland, 2009-2010

Booth, M. et al. (2014) Confirmed Bacillus anthracis infection among persons who inject drugs, Scotland, 2009-2010. Emerging Infectious Diseases, 20(9), pp. 1452-63. (doi: 10.3201/eid2009.131481) (PMID:25148307) (PMCID:PMC4178387)

Abstract

In Scotland, the 2009 outbreak of Bacillus anthracis infection among persons who inject drugs resulted in a 28% death rate. To compare nonsurvivors and survivors, we obtained data on 11 nonsurvivors and 16 survivors. Time from B. anthracis exposure to symptoms or hospitalization and skin and limb findings at presentation did not differ between nonsurvivors and survivors. Proportionately more nonsurvivors had histories of excessive alcohol use (p = 0.05) and required vasopressors and/or mechanical ventilation (p≤0.01 for each individually). Nonsurvivors also had higher sequential organ failure assessment scores (mean ± SEM) (7.3 ± 0.9 vs. 1.2 ± 0.4, p<0.0001). Antibacterial drug administration, surgery, and anthrax polyclonal immune globulin treatments did not differ between nonsurvivors and survivors. Of the 14 patients who required vasopressors during hospitalization, 11 died. Sequential organ failure assessment score or vasopressor requirement during hospitalization might identify patients with injectional anthrax for whom limited adjunctive therapies might be beneficial.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Hart, Professor Andrew and Booth, Dr Malcolm
• Authors: Booth, M., Donaldson, L., Cui, X., Sun, J., Cole, S., Dailsey, S., Hart, A., Johns, N., McConnell, P., McLennan, T., Parcell, B., Robb, H., Shippey, B., Sim, M., Wallis, C., and Eichacker, P. Q.
• College/School: College of Medical Veterinary and Life Sciences > School of Life Sciences; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Emerging Infectious Diseases
• Publisher: U.S. Department of Health and Human Services
• ISSN: 1080-6040
• ISSN (Online): 1080-6040