Severe SSTI in people who inject drugs

Notes

SSTIs in injecting drug users can be caused by a large variety of pathogens, including S. aureus and Group A Streptococcus/S. pyogenes, which are common in all types of SSTI, but also by anaerobes, environmental organisms and gram negative enterobacteriaceae, especially if the injection site is in the groin area.

Rarely, PWIDs acquire wound botulism. See sampling section for sampling advice in suspected wound botulism.

If necrotising fasciitis is suspected, an urgent surgical review should be requested, as debridement is life-saving.

Advice from Microbiology or Infectious Diseases on antimicrobial therapy should be sought as soon as possible.