The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.
Injection Drug Use-Associated Candidemia: Incidence, Clinical Features, and Outcomes, East Tennessee, 2014–2018
Open accessAbstract
Background: Injection drug use (IDU) is an established but uncommon risk factor for candidemia. Surveillance for candidemia is conducted in East Tennessee, an area heavily impacted by the opioid crisis and IDU. We evaluated IDU-associated candidemia to characterize the epidemiology and estimate the burden. Methods: We assessed the proportion of candidemia cases related to IDU during January 1, 2014–September 30, 2018, estimated candidemia incidence in the overall population and among persons who inject drugs (PWID), and reviewed medical records to compare clinical features and outcomes among IDU-associated and non-IDU candidemia cases. Results: The proportion of IDU-associated candidemia cases in East Tennessee increased from 6.1% in 2014 to 14.5% in 2018. Overall candidemia incidence in East Tennessee was 13.5/100 000, and incidence among PWID was 402–1895/100 000. Injection drug use-associated cases were younger (median age, 34.5 vs 60 years) and more frequently had endocarditis (39% vs 3%). All-cause 30-day mortality was 8% among IDU-associated cases versus 25% among non-IDU cases. Conclusions: A growing proportion of candidemia in East Tennessee is associated with IDU, posing an additional burden from the opioid crisis. The lower mortality among IDU-associated cases likely reflects in part the younger demographic; however, Candida endocarditis seen among approximately 40% underscores the seriousness of the infection and need for prevention.
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Injection drug use was more recently identified as an important risk factor for non-health care-associated candidemia.
“Injection drug use was more recently identified as an important risk factor for non-health care–associated candidemia (8–10).”
From Population-Based Active Surveillance for Culture-Confirmed Candidemia — 10 Sites, United States, 2017–2021 (2025) · cites this paper as [8]
The introduction identifies injection drug use as an under-appreciated risk factor for candidemia, supporting the risk-factor claim. But the Discussion says most injection drug use-associated cases in this study involved recent hospitalization and that healthcare-associated risk factors may contribute more than expected. The paper therefore does not establish the claim specifically for non-healthcare-associated candidemia. (LLM, conf=0.87)
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Jenkins, E. N., Gold, J. A. W., Benedict, K., Lockhart, S. R., Berkow, E. L., Dixon, T., Shack, S. L., Witt, L. S., Harrison, L. H., Seopaul, S., et al. (2025) · MMWR. Surveillance Summaries · doi:10.15585/mmwr.ss7404a1 · Cited by 43
“Injection drug use was more recently identified as an important risk factor for non-health care–associated candidemia ( 8 – 10 ).”
Self-citation
Metadata
- Authors
- Rossow, J. A., Gharpure, R., Brennan, J., Relan, P., Williams, S. R., Vallabhaneni, S., Jackson, B. R., Graber, C. R., Hillis, S. R., Schaffner, W., Dunn, J. R., & Jones, T. F.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Vanderbilt University (US)
- Vanderbilt University Medical Center (US)
- Tennessee Department of Health (US)
- Corresponding author
- Rossow, John A
- ORCID
- Venue
- The Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-09-02
- Volume
- 222
- Issue
- Supplement_5
- Pages
- S442-S450
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- PMC
- PMC8186399
- OpenAlex
- W3081802697
- Cited by
- 17
- References
- 6
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 2 · 2022: 1 · 2021: 3 · 2020: 1
- FWCI
- 0.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Infectious Diseases (publishedVersion, public-domain)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Centers for Disease Control and Prevention (U50CK000198)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Keywords
- candidemia, intravenous drug use, people who inject drugs, Candida endocarditis, opioid epidemic, candidemia incidence, mortality, East Tennessee, surveillance (medicine)
- MeSH terms
- Adult, Age Factors, Candida, Endocarditis, Female, Humans, Male, Medical Records, Risk Factors, Tennessee, Substance Abuse, Intravenous, Incidence, Hospital Mortality, Drug Users, Candidemia, Epidemiological Monitoring
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