Culture-proven skin and soft tissue infections among patients admitted at a tertiary hospital from 2013 to 2017: a five-year review

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

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Keywords

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

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