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  1. Wound botulism associated with black tar heroin among injecting drug users.

    Article - En anglais

    Context. - Wound botulism (WB) is a potentially lethal, descending, flaccid, paralysis that results when spores of Clostridium botulinum germinate in a wound and elaborate neurotoxin.

    Since 1988, California has experienced a dramatic increase in WB associated with injecting « black tar » heroin (BTH), a dark, tarry form of the drug.


    - To identify risk factors for WB among injecting drug users (IDUs).


    - Case-control study based on data from in-person and telephone interviews.


    - Case patients (n=26) were IDUs who developed WB from January 1994 through February 1996.

    Controls (n=110) were IDUs newly enrolled in methadone detoxification programs in 4 counties.

    Main Outcome Measures

    - Factors associated with the development of WB.


    - Among the 26 patients, the median age was 41.5 years, 15 (58%) were women, 14 (54%) were non-Hispanic white, 11 (42%) were Hispanic, and none were positive for the human immunodeficiency virus.

    Nearly all participants (96% of patients and 97% of controls) injected BTH, and the mean cumulative dose of BTH used per month was similar for patients and controls (27 g and 31 g, respectively ; P=6).

    Patients were more likely than controls to inject drugs subcutaneously or intramuscularly (92% vs 44%, P<. 001) and used this route of drug administration more times per month (mean, 67 vs 24, P<. 001), with a greater cumulative monthly dose of BTH (22.3 g vs 6.3 g, P<. 001). (...)

    Mots-clés Pascal : Botulisme, Bactériose, Infection, Toxicomanie, Diamorphine, Voie intraveineuse, Plaie, Complication, Epidémiologie, Facteur risque, Homme, Californie, Etats Unis, Amérique du Nord, Amérique, Toxicité

    Mots-clés Pascal anglais : Botulism, Bacteriosis, Infection, Drug addiction, Heroin, Intravenous administration, Wound, Complication, Epidemiology, Risk factor, Human, California, United States, North America, America, Toxicity

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0203125

    Code Inist : 002B03D. Création : 11/09/1998.