Abstract
Skin and skin structure infection (SSSI) is classified as complicated (cSSSI) if it involves deep subcutaneous tissue or requires surgery. Factors associated with blood culture sampling and bacteremia have not been established in patients with cSSSI. Moreover, the benefit of information acquired from positive blood culture is unknown. The aim of this study was to address these important issues. In this retrospective population-based study from two Nordic cities, a total of 460 patients with cSSSI were included. Blood cultures were drawn from 258 (56.1%) patients and they were positive in 61 (23.6%) of them. Factors found to be associated with more blood culture sampling in multivariate analysis were diabetes, duration of symptoms shorter than 2 days and higher C-reactive protein (CRP) level. Whereas factors associated with less frequent blood culture sampling were peripheral vascular disease and a surgical wound infection. In patients from whom blood cultures were taken, alcohol abuse was the only factor associated with culture positivity, as CRP level was not. Patients with a positive blood culture had antibiotic streamlining more often than non-bacteremic patients. A high rate of blood culture positivity in patients with cSSSI was observed. Factors related to more frequent blood culture sampling were different from those associated with a positive culture.
Highlights
Skin and skin structure infections (SSSIs) are among the most common bacterial infections in patients presenting in emergency rooms and their incidence is rising [1,2,3]
Factors associated with blood culture sampling were analysed using multivariate logistic regression analysis and factors associated with bacteremia were analysed by comparing blood culture positive patients with blood culture negative patients
Streptococci and Staphylococcus aureus corresponded for 84% of cases
Summary
Skin and skin structure infections (SSSIs) are among the most common bacterial infections in patients presenting in emergency rooms and their incidence is rising [1,2,3]. Initially designed for the clinical trials, the umbrella term cSSSI is still useful in the detection of the most severe forms of SSSIs [5]. Blood cultures are not routinely recommended for patients with SSSI [6, 7]. This is mainly because positive findings have. Male gender and cellulitis were associated with blood culture sampling and bacteremia with later clinical stability [14, 15]. We analysed further from the same real-life setup factors predicting and associated with blood culture positivity and how the knowledge of blood culture positivity affected the treatment
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