Staphylococcus aureus endocarditis associated with injecting new psychoactive substances

S S Joshi, N Henderson, D J Griffith, P A Henriksen, M A Denvir, K F Macsween, C L Mackintosh, D Inverarity

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

BACKGROUND: Staphylococcus aureus infective endocarditis (IE) associated with injection of new psychoactive substances (NPS) in Edinburgh from 2014 to 2016 was observed. We compared these infections with a series of S. aureus IE cases in a non-injecting population within Edinburgh.

METHODS: NPS-associated S. aureus IE diagnosed between 1 January 2014 and 31 May 2016 in persons who inject drugs (PWID) were compared with a series of S. aureus IE cases from non-PWID.

RESULTS: There was a fourfold increase in the annual incidence of S. aureus IE, mainly due to NPS use in PWID. A larger vegetation diameter was seen on echocardiogram in PWID vs non-PWID (median 1.7 cm vs 0.65 cm; p = 0.009) with more embolic complications in PWID (15 PWID vs 1 non-PWID; p = 2.1 x 10-7) but no difference in 90-day mortality (2 PWID vs 4 non-PWID; p = 0.39).

CONCLUSIONS: NPS-associated S. aureus IE correlated with complications, such as deep organ embolic abscesses, that were different from non-PWID S. aureus IE. The alarming increase in incidence resolved with targeted public health and legislative measures.

Original languageEnglish
Pages (from-to)304-310
Number of pages7
JournalJournal of the Royal College of Physicians of Edinburgh
Issue number4
Publication statusPublished - Dec 2018


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