Factors associated with blood culture positivity in patients with complicated skin and skin structure infection—a population-based study

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.

Staphylococcus aureus bacteremia in alcoholics

“…The connection between alcoholism and increased risk and severity of infectious diseases, including blood culture positive infections, is well documented [ 2 , 4 , 5 , 32 , 33 ]. Prior reports have documented that alcoholics make up 7–14% of SAB patients [ 11 – 14 ].…”

“…Alcoholism increases the occurrence of various infectious diseases such as bacterial pneumonia and blood culture-positive infections. Furthermore, alcoholism deteriorates prognosis and increases mortality in bacterial pneumonia and blood culture-positive infections [2][3][4][5]. The connection between alcoholism and increased risk and severity of infections is presented as multifactorial [2,6].…”

The Diagnostic Value of Blood Next-Generation Sequencing in Early Surgical Site Infection After Spine Surgery

“…A previous study demonstrated that the rate of positivity in blood culture might be relatively low in patients with surgical site infections following spine surgery. [38][39][40] Although blood NGS is rarely used in the determination of orthopedic infections, it has already been widely used in other fields. For instance, Zhou et al 26 reported that multiorgan sepsis, including lumbar spine sepsis caused by Klebsiella pneumoniae, could be diagnosed by blood NGS.…”

“…A previous study demonstrated that the rate of positivity in blood culture might be relatively low in patients with surgical site infections following spine surgery. 38–40 …”

“…However, some noninfected patients might be misdiagnosed as infected patients by drainage fluid NGS assessment. Because the blood was sterile in the noninfected patients, 25 , 38 , 42 blood NGS could be used to accurately distinguish the infected patients from the noninfected patients in this study. Blood culture was also performed in this study.…”