Low yield of blood and wound cultures in patients with skin and soft-tissue infections

Torres, J.; Avalos, Nathaniel; Echols, Lamarr; Mongelluzzo, Jillian; Rodriguez, Robert M.

doi:10.1016/j.ajem.2017.05.039

Cited by 17 publications

(9 citation statements)

References 14 publications

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“…The bacteremia rate in our cohort was 18.3% among the patients with blood culture drawn, a value situated in the high range of those previously reported in cellulitis [4][5][6][7][8][9][10][11][12][13][14][15][16], although rates of 18.7% [8] and 21.3% [9] have been reported in hospitalized patients like ours. Of note is that blood cultures were positive in only 24.4% of patients with sepsis.…”

Section: Discussionsupporting

confidence: 70%

“…3 Internal Medicine Service, Hospital de Povisa, Vigo, Spain. 4 Infectious Diseases Unit, Hospital Universitario Central de Asturias, Oviedo, Spain. 5 Internal Medicine Service, Hospital Dr Peset, Valencia, Spain.…”

Section: Acknowledgementsmentioning

confidence: 99%

“…Cellulitis can lead to bacteremia and ultimately trigger sepsis development. The frequency of bacteremia in patients with cellulitis ranges from 2 to 21.3% among patients for whom blood cultures were available, depending on the study, setting and typology of the cases analyzed [4][5][6][7][8][9][10][11][12][13][14][15][16]. Taking into account that most cases of cellulitis are treated in the ambulatory setting and that blood cultures are not obtained in many hospitalized patients with less severe cellulitis, populations in which expectedly bacteremia occurs more infrequently, the overall prevalence of positive blood cultures considering the full spectrum of cellulitis would be even lower.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with sepsis development in 606 Spanish adult patients with cellulitis

Collazos

Fuente

et al. 2020

BMC Infect Dis

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Background: Cellulitis, a frequent cause of admission of adult patients to medical wards, occasionally evolves to sepsis. In this study we analyze the factors related to sepsis development. Methods: Prospective and observational study of 606 adult patients with cellulitis admitted to several Spanish hospitals. Comorbidities, microbiological, clinical, lab, diagnostic, and treatment data were analyzed. Sepsis was diagnosed according to the criteria of the 2016 International Sepsis Definitions Conference. Multiple logistic regression modelling was performed to determine the variables independently associated with sepsis development. Results: Mean age was 63.4 years and 51.8% were men. Overall 65 (10.7%) patients developed sepsis, 7 (10.8%) of whom died, but only 4 (6.2%) due to cellulitis. Drawing of blood (P < 0.0001) or any (P < 0.0001) culture, and identification of the agent (P = 0.005) were more likely among patients with sepsis. These patients had also a longer duration of symptoms (P = 0.04), higher temperature (P = 0.03), more extensive cellulitis (P = 0.02), higher leukocyte (P < 0.0001) and neutrophil (P < 0.0001) counts, serum creatinine (P = 0.001), and CRP (P = 0.008) than patients without sepsis. Regarding therapy, patients with sepsis were more likely to undergo changes in the initial antimicrobial regimen (P < 0.0001), received more antimicrobials (P < 0.0001), received longer intravenous treatment (P = 0.03), and underwent surgery more commonly (P = 0.01) than patients without sepsis. Leukocyte counts (P = 0.002), serum creatinine (P = 0.003), drawing of blood cultures (P = 0.004), change of the initial antimicrobial regimen (P = 0.007) and length of cellulitis (P = 0.009) were independently associated with sepsis development in the multivariate analysis. Conclusions: Increased blood leukocytes and serum creatinine, blood culture drawn, modification of the initial antimicrobial regimen, and maximum length of cellulitis were associated with sepsis in these patients.

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Section: Discussionsupporting

confidence: 70%

Section: Acknowledgementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors associated with sepsis development in 606 Spanish adult patients with cellulitis

Collazos

Fuente

et al. 2020

BMC Infect Dis

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“…There is no justification for the cultures of abandoned materials and cultures of blood (before the addition of antibiotic treatment) in the following cases [90,91]:…”

Section: Diagnosis Of Complicated Abscess and Soft Tissues Infectionsmentioning

confidence: 99%

Bacterial Skin Abscess

Radhi¹,

AL-Rubea²,

Hindi³

et al. 2021

Insights Into Drug Resistance in Staphylococcus Aureus

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Patients with skin and soft tissue infections may appear with the abscess. Erroneous diagnosis of these entities is common, and should carefully consider the possible alternative diagnoses. Risk for developing skin abscess factors includes disruption of the skin barrier, edema, venous insufficiency, and immune suppression. However, healthy individuals who have no risk factors may also develop these diseases. The most common microbiologic cause of abscess, a commonly group Streptococcus or Streptococcus pyogenes; Staphylococcus aureus (including methicillin-resistant strains) is a notable but less common cause. The most common microbiologic cause of skin abscess is S. aureus; a skin abscess can be caused by more than one pathogen. The diagnosis is based on skin abscess usually on the clinical manifestations. It must be subject to patients with disposable abscess incision and drainage, with a test of culture and susceptibility of materials wet. There is no justification for the blood of patients in the cultures of the abovementioned circumstances. It can be a useful radiographic examination to determine whether the skin abscess is present (via ultrasound) to distinguish cellulitis from osteomyelitis (via magnetic resonance imaging). There may be a justification for radiological assessment in patients with immune suppression, diabetes, venous insufficiency, or lymphedema in patients with persistent symptoms of systemic lymphatic obstruction.

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“…Acute bacterial skin and skin structure infections (ABSSSI) and community-acquired bacterial pneumonia (CABP) are common reasons for hospital admission. While uncommon (<10% of cases), these infections are associated with secondary bacteremia, and the optimal clinical management of these cases is undetermined [ 1 , 2 ].…”

mentioning

confidence: 99%

Clinical Efficacy of Patients With Secondary Bacteremia Treated With Omadacycline: Results From Phase 3 Acute Bacterial Skin and Skin Structure Infections and Community-Acquired Bacterial Pneumonia Studies

Sakoulas

Eckburg

Amodio-Groton

et al. 2021

Open Forum Infectious Diseases

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Low yield of blood and wound cultures in patients with skin and soft-tissue infections

Cited by 17 publications

References 14 publications

Factors associated with sepsis development in 606 Spanish adult patients with cellulitis

Factors associated with sepsis development in 606 Spanish adult patients with cellulitis

Bacterial Skin Abscess

Clinical Efficacy of Patients With Secondary Bacteremia Treated With Omadacycline: Results From Phase 3 Acute Bacterial Skin and Skin Structure Infections and Community-Acquired Bacterial Pneumonia Studies

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