Clinical Microbiology in Xylazine-Associated Wound Infections

作者：Deanna M Berg, Amanda Binkley, Sean Foster, Matthew Hinton, Derek Peiffer, Samantha Huo, Jessie Torgersen, Christina Maguire · 发表于：Open Forum Infectious Diseases · 年份：2025 · DOI：10.1093/ofid/ofaf384 · 被引用次数：2 · 研究领域：Veterinary Pharmacology and Anesthesia、Antibiotics Pharmacokinetics and Efficacy、Orthopedic Infections and Treatments

Abstract Background Injection drug use (IDU) containing xylazine has been associated with the development of chronic necrotic wounds, albeit not all are of infectious etiology. This study describes the clinical microbiology of xylazine-associated wound infections to guide antimicrobial prescribing. Methods We conducted a retrospective, single-center cohort study of adults hospitalized with xylazine-associated wound infections related to IDU from 1 April 2022 to 1 December 2023. Patients were included if they received antimicrobials for suspected wound infections, along with either a positive urine xylazine test or urine fentanyl test with patient-reported xylazine use. Microbiology results of wound and blood cultures were collected. Antimicrobial spectrum and hospital outcomes were described, including multidrug-resistant organisms’ isolation, duration of therapy, in-hospital mortality, and 30-day readmission. Results A total of 166 patients were included, of whom 81 had wound cultures and 153 had blood cultures collected; more than half had positive cultures (93/166 [56.0%]). Most wound cultures were positive (78/81 [96.3%]), compared to 25.5% of blood cultures (39/153). Approximately 40% of wound cultures were obtained operatively. Gram-positive organisms were isolated in nearly all wound (73/78 [93.6%]) and blood (37/39 [94.9%]) cultures. The predominant causative organisms were methicillin-resistant Staphylococcus aureus (MRSA) (52/93 [55.9%]) and β-hemolytic streptococci...