Clinical Microbiology in Xylazine-Associated Wound Infections.

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.

Delays in antibiotic redosing: Association with inpatient mortality and risk factors for delay.

Objective: Although timely administration of antibiotics has an established benefit in serious bacterial infection, the majority of studies evaluating antibiotic delay focus only on the first dose. Recent evidence suggests that delays in redosing may also be associated with worse clinical outcome. In light of the increasing burden of boarding in Emergency Departments (ED) and subsequent need to redose antibiotic in the ED, we examined the association between delayed second antibiotic dose administration and mortality among patients admitted from the ED with a broad array of infections and characterized risk factors associated with delayed second dose administration.

Providing Incentive for Emergency Physician X-Waiver Training: An Evaluation of Program Success and Postintervention Buprenorphine Prescribing.

Study Objective: Emergency department (ED) initiation of buprenorphine for patients with opioid use disorder increases treatment engagement but remains an uncommon practice. One important barrier to ED-initiated buprenorphine is the additional training requirement (X waiver). Our objective is to evaluate the influence of a financial incentive program on emergency physician completion of X-waiver training.

Impact of a low intensity and broadly inclusive ED care coordination intervention on linkage to primary care and ED utilization.

Objective: We aim to evaluate the effectiveness of a broadly inclusive, comparatively low intensity intervention linking ED patients to a primary care home.

Methods: This retrospective cohort study evaluated ED patients referred for primary care linkage in a large, urban, academic ED. A care coordination specialist performed a brief interview to gauge access barriers and provide a clinic referral with optional scheduling assistance.

A mimic of soft tissue infection: intra-arterial injection drug use producing hand swelling and digital ischemia.

Background: Inadvertent intra-arterial injection of illicit substances is a known complication of injection drug use and can lead to severe complications, including infection, ischemia and compartment syndrome. Identifying complications of intra-arterial injection can be difficult, as clinical manifestations overlap with other more common conditions such as cellulitis and soft tissue infection, and a history of injection drug use is frequently not disclosed.

Methods: A 37-year-old male patient presented with 24 hours of right hand pain, erythema and swelling.