University of Vermont Medical Center in Burlington saw an 814% increase in blood infections, and the increase coincides with the arrival of xylazine as an illicit drug, according to a CDC report.
In 2020 and 2021, the hospital recorded seven group A Streptococcus infections; 64 cases were noted the following two years.
"The increase coincided with the introduction of xylazine into the drug supply," the CDC report said. Opioids are increasingly being laced with xylazine, a nonopioid animal tranquilizer that the CDC said is associated with necrosis, making users more susceptible to infection.
There are few withdrawal treatments for this drug mix.
Of the 64 infections, 45 (70%) happened among people who inject drugs, and for 26 (62%) of the cases, patients reported experiencing homelessness at the time, according to the report. Many of the patients sought wound care services and were diagnosed with a bloodstream infection.
More than half of the patients who were known to be persons who inject drugs collectively sought aid 59 times — or between one and six visits each — at UVMMC emergency or urgent care departments six months before their GAS bacteremia diagnosis.
Nineteen cases required wound debridement, and for 23 cases patients declined admission or left the hospital against medical advice. Two patients died during their hospitalization for GAS bacteremia.
"In response to these findings, UVMMC is working to improve linkage to care for both opioid use disorder and wound care and is exploring collaborative efforts with local nongovernmental organizations and public health authorities to deliver wound care services in community settings," the report said.
In conclusion, the CDC said clinicians should consider GAS infections among people who use drugs and have symptoms of bacteremia, especially in wound cases. Increased access to wound care services in sites available to this population may also lead to earlier treatment and improve care.