1887

Abstract

In 2000, an unusual increase of morbidity and mortality among illegal injecting drug users in the UK and Ireland was reported and was identified as the likely source of the serious infection, although infections due to and were also reported. Because heroin was a possibile source of infection, this study investigated the microflora of heroin samples seized in England during 2000 and 2002. Two methods were developed for the examination of the microflora of heroin. The first consisted of suspension of the drug in maximum recovery diluent (MRD) which was inoculated directly into Clostridium Botulinum Isolation Cooked Meat Broth (CBI). The second method rendered the heroin soluble in citric acid, concentrated particulate material (and bacterial cells) by filtration and removed heroin residues by washing with citric acid and phosphate-buffered saline before placing the filter in CBI broth. Duplicate CBI broths from both methods were incubated without heating and after heating at 60°C for 30 min. Subcultures were made after incubation for 7 and 14 days on to eight different solid media. The methods were evaluated with heroin samples spiked with either or spore suspensions; recovery of 10 spores in the original sample was demonstrated. Fifty-eight heroin samples were tested by citric acid solubilisation and 34 by the MRD suspension technique. Fifteen different gram-positive species of four genera were recognised. No fungi were isolated. Aerobic endospore-forming bacteria ( spp. and ) were the predominant microflora isolated and at least one species was isolated from each sample. was the most common species and was isolated from 95% of all samples, with isolated from 40%. Between one and five samples yielded cultures of , , , and spp. were isolated from 23 (40%) samples; and were the most common and were cultured from 13 (22%) and 6 (10%) samples respectively. One or two samples yielded cultures of , and . The remainder of the flora detected comprised two samples contaminated with and two samples with either or . Multiple bacterial species were isolated from 43 (74%) samples, a single species from the remaining 15. In 13 samples alone was isolated, in one alone and in one sample alone. and were not isolated from any of the heroin samples. Recommendations for the optimal examination of the microflora of heroin are given.

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2002-11-01
2024-03-29
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