TY - JOUR AU - Poowanawittayakom, Nongnooch AU - Dutta, Anamika AU - Stock, Shannon AU - Touray, Sunkaru AU - Ellison, Richard AU - Levitz, Stuart T1 - Reemergence of Intravenous Drug Use as Risk Factor for Candidemia, Massachusetts, USA T2 - Emerging Infectious Disease journal PY - 2018 VL - 24 IS - 4 SP - 631 SN - 1080-6059 AB - The epidemic of illicit intravenous drug use (IVDU) in the United States has been accompanied by a surge in drug overdose deaths and infectious sequelae. Candida albicans infections were associated with injection of contaminated impure brown heroin in the 1970s–1990s; however, candidiasis accompanying IVDU became considerably rarer as the purity of the heroin supply increased. We reviewed cases of candidemia occurring over a recent 7-year period in persons >14 years of age at a tertiary care hospital in central Massachusetts. Of the 198 patients with candidemia, 24 cases occurred in patients with a history of IVDU. Compared with non-IVDU patients, those with a history of IVDU were more likely to have non-albicans Candida, be co-infected with hepatitis C, and have end-organ involvement, including endocarditis and osteomyelitis. Thus, IVDU appears to be reemerging as a risk factor for invasive candidiasis. KW - candidemia KW - candidiasis KW - Candida albicans KW - intravenous substance abuse KW - heroin KW - endocarditis KW - fungi KW - fungal infections KW - Massachusetts KW - United States DO - 10.3201/eid2404.171807 UR - https://wwwnc.cdc.gov/eid/article/24/4/17-1807_article ER - End of Reference