{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T11:23:19Z","timestamp":1793877799361,"version":"4.7.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T00:00:00Z","timestamp":1635811200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["220406\/Z\/20\/Z"],"award-info":[{"award-number":["220406\/Z\/20\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["214178\/Z\/18\/Z"],"award-info":[{"award-number":["214178\/Z\/18\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Infection"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Infected deep vein thrombophlebitis (i-DVT) in people who inject drugs (PWID) is a clinically challenging but poorly characterised disease. We undertook a retrospective observational study of 70 PWID presenting acutely with i-DVT to improve the clinical and microbiological characterisation of this disease. i-DVT was frequently associated with bacteraemia (59.1% patients with blood cultures obtained), groin abscesses (in 34.3%; of which 54.2% required surgical drainage), and septic pulmonary emboli (38.6%) requiring anticoagulation. Network analysis identified a cluster of patients presenting with respiratory symptoms but lacking typical DVT symptoms, more likely to have septic pulmonary emboli. A microbiologic diagnosis was frequently achieved (70%). Causative pathogens were predominantly gram-positive (<jats:italic>S. aureus<\/jats:italic> and streptococci, especially anginosus group), whereas gram-negative pathogens were identified very infrequently (in 6.1% of microbiological diagnoses). This suggests routine empiric therapy against gram-negative bacteria, though commonly administered, is not required. High rates of clinical cure (88.6%) were observed despite the complex nature of infections and independently of the highly variable intravenous and total antimicrobial durations received. There exists a rationale to devise pragmatic approaches to implement novel individualised treatment plans utilising oral antimicrobial therapy for i-DVT. Despite frequent healthcare interactions, opportunities to address HCV treatment and opioid substitution therapy were frequently missed during these acute admissions.<\/jats:p>","DOI":"10.1007\/s15010-021-01725-3","type":"journal-article","created":{"date-parts":[[2021,11,2]],"date-time":"2021-11-02T11:02:53Z","timestamp":1635850973000},"page":"507-511","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Infected deep vein thrombophlebitis in people who inject drugs: missed opportunities and potential for alternative antimicrobial approaches"],"prefix":"10.1007","volume":"50","author":[{"given":"Hugh","family":"McCaughan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9873-8243","authenticated-orcid":false,"given":"Clark D.","family":"Russell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D\u00e1ire T.","family":"O\u2019Shea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"issue":"5","key":"1725_CR1","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1086\/527445","volume":"46","author":"D Mertz","year":"2008","unstructured":"Mertz D, Khanlari B, Viktorin N, Battegay M, Fluckiger U. Less than 28 days of intravenous antibiotic treatment is sufficient for suppurative thrombophlebitis in injection drug users. Clin Infect Dis. 2008;46(5):741\u20134.","journal-title":"Clin Infect Dis"},{"issue":"1","key":"1725_CR2","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/S0002-9343(96)00070-8","volume":"101","author":"AW Heldman","year":"1996","unstructured":"Heldman AW, Hartert TV, Ray SC, et al. Oral antibiotic treatment of right-sided staphylococcal endocarditis in injection drug users: prospective randomized comparison with parenteral therapy. Am J Med. 1996;101(1):68\u201376.","journal-title":"Am J Med"},{"issue":"7","key":"1725_CR3","doi-asserted-by":"publisher","first-page":"e185220-e","DOI":"10.1001\/jamanetworkopen.2018.5220","volume":"1","author":"L Rodger","year":"2018","unstructured":"Rodger L, Glockler-Lauf SD, Shojaei E, et al. Clinical characteristics and factors associated with mortality in first-episode infective endocarditis among persons who inject drugs. JAMA Netw Open. 2018;1(7):e185220-e.","journal-title":"JAMA Netw Open"},{"key":"1725_CR4","doi-asserted-by":"crossref","unstructured":"Freeman TC, Horsewell S, Patir A, et al. Graphia: A platform for the graph-based visualisation and analysis of complex data. bioRxiv 2020: 2020.09.02.279349.","DOI":"10.1101\/2020.09.02.279349"},{"issue":"4","key":"1725_CR5","first-page":"293","volume":"37","author":"MBD Hakeem","year":"2007","unstructured":"Hakeem MBD. Septic deep venous thrombophlebitis and distant emboli in injecting drug users \u2013 treatment experience and outcome. J R Coll Phys Edinb. 2007;37(4):293\u20139.","journal-title":"J R Coll Phys Edinb"},{"issue":"27\u201328","key":"1725_CR6","first-page":"386","volume":"132","author":"F F\u00e4h","year":"2002","unstructured":"F\u00e4h F, Zimmerli W, Jordi M, Schoenenberger RA. Septic deep venous thrombosis in intravenous drug users. Swiss Med Wkly. 2002;132(27\u201328):386\u201392.","journal-title":"Swiss Med Wkly"},{"issue":"10","key":"1725_CR7","doi-asserted-by":"publisher","first-page":"e650","DOI":"10.1093\/cid\/ciaa365","volume":"71","author":"LR Marks","year":"2020","unstructured":"Marks LR, Liang SY, Muthulingam D, et al. Evaluation of partial oral antibiotic treatment for persons who inject drugs and are hospitalized with invasive infections. Clin Infect Dis. 2020;71(10):e650\u20136.","journal-title":"Clin Infect Dis"},{"issue":"5","key":"1725_CR8","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1056\/NEJMoa1710926","volume":"380","author":"HK Li","year":"2019","unstructured":"Li HK, Rombach I, Zambellas R, et al. Oral versus intravenous antibiotics for bone and joint infection. N Engl J Med. 2019;380(5):425\u201336.","journal-title":"N Engl J Med"},{"issue":"5","key":"1725_CR9","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1056\/NEJMoa1808312","volume":"380","author":"K Iversen","year":"2019","unstructured":"Iversen K, Ihlemann N, Gill SU, et al. Partial oral versus intravenous antibiotic treatment of endocarditis. N Engl J Med. 2019;380(5):415\u201324.","journal-title":"N Engl J Med"},{"key":"1725_CR10","unstructured":"NHS National Services Scotland, Information Services Division. Drug-Related Hospital Statistics Scotland 2017\/18, 2019."}],"container-title":["Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-021-01725-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s15010-021-01725-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s15010-021-01725-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T18:08:07Z","timestamp":1648058887000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s15010-021-01725-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,2]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["1725"],"URL":"https:\/\/doi.org\/10.1007\/s15010-021-01725-3","relation":{},"ISSN":["0300-8126","1439-0973"],"issn-type":[{"value":"0300-8126","type":"print"},{"value":"1439-0973","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,2]]},"assertion":[{"value":"18 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This work was approved by the NHS Lothian Infection Service Quality Improvement Team.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}