Designing a filter to prevent infections with spore-forming bacteria in Heroin-injecting drug users

First published: 10/05/2019 | Last updated: May 20th, 2019

Aims: There have been several outbreaks of anthrax and botulism amongst heroin injectors in UK and Europe. It is thought to be caused by heroin contaminated with spore-forming bacteria. In our work, our aim was to design a filter that: (a) efficiently removes both particulates and bacterial spores from heroin samples, (b) is easy to use and acceptable to injectors, and (c) does not retain any significant amounts of the active ingredient in the Heroin.

Design: A prototype filter was designed and different filter membranes were tested to assess retention volume, filtration time and efficiency of filtration of bacteria spores.

Setting: 100mg of brown heroin and 50 mg citric acid was added to 0.7 mL distilled water, and this was heated to boil until the solution became clear. The volume was then corrected for evaporation. Heroin samples were spiked with spores from the non-pathogenic bacterium Bacillus subtilis. The binding of heroin’s active ingredients to different types of membrane filters was determined using ultra-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS).

Findings: A prototype filter was developed. Efficient filtration of heroin samples was achieved by combining a prefilter (to remove particles) and an 0.22µm filter (to remove bacterial spores). Polyethersulfone (PES) showed the shortest filtration time and successfully removed B. subtilis spores. No or negligible amounts of active ingredients in heroin were retained by the PES membrane.

Conclusions: This study successfully produced a prototype filter designed to filter bacterial spores from heroin samples.

Co-Authors

Jenny Scott

Jenny Scott is a pharmacist. She is a senior lecturer at the University of Bath and a non medical prescriber with Turning Point. She is interested in evidence based harm reduction, specifically the laboratory performance of injecting paraphernalia and the clinical outcomes of such. She is keen to develop a filter for use in clinical practice, that would prevent mortality and morbidity from infections such as anthrax. She is also interested in community pharmacy services for people who use drugs and ways in which such services can be improved. She would like every pharmacy to provide effective, person centred harm reduction and treatment services that benefit individuals and society.

Albert Bolhuis

Albert Bolhuis obtained his PhD from the University of Groningen (The Netherlands) in 1999, where he worked on protein secretion by the Gram-positive organism in Bacillus subtilis. After his PhD he moved to the University of Warwick, where he continued to work on protein secretion in Gram negative bacteria and extremophiles. This work was initially funded through an EMBO fellowship, which was followed in 2001 by the award of a Royal Society University Research Fellowship. In 2007, Bolhuis moved to the University of Bath (Department of Pharmacy and Pharmacology) to take up a position as Senior Lecturer in Microbiology. His work focussed more on pathogenic organisms and how they form so-called biofilms. These are sessile communities of cells that are particularly tolerant to antibiotics and other biocides. Biofilms are a common cause of infections, and an important aim therefore is to develop novel strategies to either remove of kill these pathogenic microorganisms.


Conflicts of interest:

Funding Sources: Medical Research council – The Confidence in Concept Scheme

no conflict of interest

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Dr Nour Alhusein