(Last Updated On: October 29, 2018)

Authors: Lauren Margaret T. Hao, MD, Maria Christina C. Gonzalez, MD, Hazel C. Hao, MD, Arnelfa C. Paliza, MD, FPDS

Abstract

Introduction: Skin and soft tissue infections (SSTIs) are commonly encountered in local practice. Their incidence has increased because of emergence of antibiotic resistance making their treatment more challenging.

Objectives: To determine the epidemiological characteristics of admitted SSTI patients in a tertiary institution from January 2013 to December 2017.

Methods: A chart review of admitted patients with culture-proven SSTIs was conducted. SSTIs were categorized following the Infectious Disease Society of America classification.

Results: Patients with culture-proven SSTI comprised 0.6% of total admissions: 191 cases were purulent, 206 non-necrotizing non-purulent, 8 necrotizing non-purulent, 27 surgical site infections, 113 diabetic foot infections and 12 impetigo/ecthyma. Males comprised 56% and 89.6% belonged to the adult/geriatric group. The leg was the most common area affected. The most prevalent predisposing factor was trauma (76.9%), and 44.0% had diabetes mellitus. Tachycardia was the most frequent sign of systemic inflammatory response syndrome (18.3%). Majority (82.1%) had negative blood cultures. Staphylococcus aureus was the most common organism in all SSTIs, 63.5% of which were methicillin-resistant. Escherichia coli was the most common pathogen in diabetic foot infections. Half of the impetigo/ecthyma group had Pseudomonas aeruginosa. Top drug given as empiric and culture- guided treatment was clindamycin (35.4% and 39.3% respectively). Around 77.6% of patients treated empirically improved. Change of antibiotic regimen was done in 18.7% of patients. The most common complication was osteomyelitis (6.6%). Majority (90.4%) of patients were discharged improved.

Conclusion: This study provides information on the patient’s characteristics, microbiological diagnoses, treatment patterns and clinical outcomes of SSTIs among hospitalized patients.

Citation

Keywords

Skin and soft tissue infections, Retrospective study, Purulent, Diabetic foot
infections, Surgical site infections

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