注射吸毒者（PWID）血流感染后与健康相关的生活质量损害。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection Pub Date : 2025-01-01 DOI:10.1016/j.jinf.2024.106375

A. Richards , I. Mortimer , P. Burns , E. Plevneshi , G. Barlow , N. Easom , PJ. Lillie

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引用次数: 0

摘要

背景：注射吸毒者（PWID）的金黄色葡萄球菌（SA）和A群链球菌（GAS）血流感染（BSI）发生率较高。BSI后与健康相关的生活质量结果知之甚少。方法：我们对SA或GAS引起的BSI患者进行了前瞻性先导队列研究。在基线、出院后28天和感染后6个月，使用经过验证的工具(EQ5-5D-5L、医院焦虑和抑郁评分（HADS）和蒙特利尔认知评估（MOCA）评估健康相关的生活质量、焦虑、抑郁和认知功能。结果：在12个月的时间内招募了66名患者，其中包括17名PWID患者。对于整个队列，全球健康排名从基线到第28天有所改善（中位数为40至60，p=0.002），从第28天到第168天无显著改善（中位数为60至75，p=0.161）。在基线时，PWID患者的总体健康相关生活质量低于非PWID患者（中位数25 vs中位数45，p=0.229），持续到第28天（非PWID患者中位数65，PWID患者中位数43，p=0.036）和第168天（非PWID患者中位数75，PWID患者中位数40，p=0.035）。这一差异是由EQ-5D-5L心理健康成分和HADS评分较差造成的，PWID患者在基线时（p=0.001）和第28天（p=0.007）的HADS评分显著下降。结论：PWID在SA和GAS BSI后持续长达6个月的健康相关生活质量受损。心理健康状况不佳是其中的主要因素，进一步的研究可以澄清这是否是干预的目标。

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Health-associated quality of life impairment in people who inject drugs (PWID) after bloodstream infection

Background

People who inject drugs (PWID) have high rates of bloodstream infections (BSI) with Staphylococcus aureus (SA) and group A streptococcus (GAS). Little is known about health-related quality of life outcomes after BSI.

Methods

We performed a prospective pilot cohort study of patients with BSI due to SA or GAS. Health-related quality of life, anxiety, depression and cognitive function were assessed using validated tools (EQ5-5D-5L), Hospital Anxiety and Depression Score (HADS) and Montreal Cognitive Assessment (MOCA) at baseline, 28 days post-discharge and 6 months post-infection.

Findings

66 patients were recruited over a 12-month period, including 17 PWID. For the whole cohort, global health rank improved from baseline to day 28 (median 40 to 60, p=0.002), with no significant improvement from day 28 to day 168 (median 60 to 75, p=0.161). At baseline, PWID had lower overall health-related quality of life than non-PWID (median 25 vs 45, p=0.229), persisting at day 28 (non-PWID median 65, PWID median 43, p=0.036) and day 168 (non-PWID median 75, PWID median 40, p=0.035). This difference was driven by worse scores in the EQ-5D-5L mental health component and HADS, with HADS scores being significantly impaired in PWID at baseline (p=0.001) and day 28 (p=0.007).

Conclusion

PWID have impaired health-related quality of life after SA and GAS BSI that persists for up to 6 months. Poor mental health is the major component of this, and further studies could clarify if this is a target for intervention.

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.