{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T09:47:09Z","timestamp":1782467229548,"version":"3.54.5"},"reference-count":51,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,14]],"date-time":"2026-06-14T00:00:00Z","timestamp":1781395200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Journal of Australia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterise the clinical, microbiological and economic burden of hospital\u2010admitted, injection\u2010related infections among incarcerated people who inject drugs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Retrospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Secure unit of the Princess Alexandra Hospital, Brisbane, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Adults incarcerated in Queensland prisons who were admitted to hospital with an injection\u2010related infection between 1 July 2019 and 30 June 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Types of injection\u2010related infection, microbiological findings, requirement for surgical or radiological source control, hospital length of stay and inpatient healthcare costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 321 hospital admissions for injection\u2010related infection among 265 patients, accounting for 282 unique infections. Most patients were male (241; 90.9%), with a mean age of 33\u2009years (standard deviation [SD], 7.4\u2009years), and 76 (28.7%) identified as First Nations. The most frequent infections were soft tissue infections (77\/282; 27.3%), acute hepatitis C (64\/282; 22.7%) and cellulitis (43\/282; 15.2%). Surgical or radiological source control was required in 95 infections (34.0%), and infectious diseases consultation occurred in 130 infections (46.1%). Among 39 true\u2010positive blood cultures,\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>Staphylococcus aureus<\/jats:italic>\n                      <\/jats:styled-content>\n                      was identified in 17 (43.6%),\n                      <jats:italic>Burkholderia<\/jats:italic>\n                      species in 10 (25.6%) and non\u2010tuberculous Mycobacterium species in 3 (7.7%). Among the 218 non\u2010acute hepatitis C infections, 50 (22.9%) were hepatitis C virus (HCV) RNA positive. Overall, HCV RNA was present in 114 of 282 infections (40.4%). The total inflation\u2010adjusted inpatient cost was $8.39 million, with a median cost per infection of $11,602 (interquartile range, $7426\u2013$34,544).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Injection\u2010related infections among incarcerated people who inject drugs were associated with substantial morbidity and healthcare costs in this large hospital cohort. A wide clinical spectrum was observed, including atypical pathogens, and clinically overt acute hepatitis C requiring hospital admission. These findings describe a significant burden of preventable disease in custodial settings and support the introduction of established primary prevention and harm\u2010reduction interventions in prisons.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5694\/mja2.70224","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T02:45:52Z","timestamp":1781491552000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hospital\u2010Admitted Injection\u2010Related Infections Among Incarcerated People Who Inject Drugs in Australia: A Retrospective Cohort Study"],"prefix":"10.5694","volume":"224","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1795-6554","authenticated-orcid":false,"given":"Andrew","family":"Palmer","sequence":"first","affiliation":[{"name":"Gastroenterology and Hepatology Princess Alexandra Hospital  Woolloongabba Queensland Australia"},{"name":"Alcohol and Drug Assessment 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