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ISDS 2016 Conference Abstracts

Using Syndromic Surveillance Data to Monitor 
Endocarditis and Sepsis among Drug Users
Lana Deyneka*1, Anne Hakenewerth1, Zachary Faigen1, Amy Ising2 and Clifton Barnett2
1Epidemiology, NCDPH, Raleigh, NC, USA; 2UNC, Chapel hill, NC, USA

Objective
To describe how the state syndromic surveillance system  

(NC DETECT) was used to initiate near real time surveillance for 
endocarditis, sepsis and skin infection among drug users.

Introduction
Recreational drug use is a major problem in the United States and 

around the world. Specifically, drug abuse results in heavy use of 
emergency department (ED) services, and is a high financial burden 
to society and to the hospitals due to chronic ill health and multiple 
injection drug use complications. Intravenous drug users are at high 
risk of developing sepsis and endocarditis due to the use of a dirty or 
infected needle that is either shared with someone else or re-used. It 
can also occur when a drug user repeatedly injects into an inflamed 
and infected site or due to the poor overall health of an injection drug 
user. The average cost of hospitalization for aortic valve replacement 
in USA is about $165,000, and in order for the valve replacement to 
be successful, patients must abstain from using drugs.

Methods
We examined temporal trends of drug-related visits to hospital 

EDs, as well as drug-related related ED admissions complicated with 
endocarditis, bacteremia and sepsis.

Results
The trends in Endocarditis/Sepsis and drug-related related 

admissions appear to echo overdose related ED admissions increase. 
Patients ED return visits and hospitalizations for the same problem are 
also growing compare to the previous years. We will discuss the NC 
DETECT case definition used to monitor drug overdose/dependence 
and infection, case definition transition from ICD-9 to ICD-10 codes, 
and will share surveillance analysis results.

Conclusions
NC DETECT’s system flexibility has been important in rapidly 

establishing surveillance of infections among drug users. Near real 
time analysis on hospital, county and state levels can be performed 
using NC DETECT system reports to provide state officials, hospitals 
and LHDs with situational awareness. Limitations: Syndromic 
surveillance ED data contains less accurate information about the 
diagnosis codes, procedures, length of stay, and severity comparing 
to the hospital discharge data.

Keywords
surveillance; drug users; endocarditis; bacteremia; sepsis

References
1. Ising A, Proescholdbell S, Harmon KJ, Sachdeva N, Marshall SW,

Waller AE. Use of syndromic surveillance data to monitor poisonings 
and drug overdoses in state and local public health agencies. Injury
prevention. 2016 Apr 1;22(Suppl 1):i43-9.

2. Jennifer A. Frontera Jeremy D. Gradon Right-Side Endocarditis
in Injection Drug Users: Review of Proposed Mechanisms of
Pathogenesis Oxford Journals Medicine & Health Clinical Infectious
Diseases, Volume 30, Issue 2

3. Hannah L. F. Cooper, Joanne E. Brady, Daniel Ciccarone, Barbara
Tempalski1 Karla Gostnell, Samuel R. Friedman Increasing Infectious 
Endocarditis Admissions Among Young People Who Inject Drugs
Open Forum Infect Dis (2016) 3 (3): ofw157 Accepted July 18, 2016

*Lana Deyneka
E-mail: lana.deyneka@dhhs.nc.gov

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e124, 2017