Naslov
Clinical characteristics of cellulitis caused by Staphylococcus aureus: a retrospective study of 36 cases

Autori
Lukić, Ljiljana ; Puljiz, Ivan ; Mudrovčuć, Monika

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
3rd South-East European Conference on Travel, Tropical, Migration Medicine and HIV and 4th Croatian Congress on Travel, Tropical, Migration Medicine & HIV

Mjesto i datum
Zadar, Hrvatska, 16.09.2021. - 19.09.2021

Vrsta sudjelovanja
Poster

Vrsta recenzije
Domaća recenzija

Ključne riječi
Cellulitis ; Staphylococcus aureus ; retrospective study

Sažetak
Objectives: The goal of this study was to examine the clinical characteristics and course of Staphyloccocus aureus (SA) cellulitis in our patients. Methods: We retrospectively analyzed data of 36 patients hospitalized for cellulitis in a tertiary hospital centre in one year with SA identified in microbiological specimens (wound swabs -30, blood cultures -6). 28 isolates were MSSA, while 8 were MRSA. Statistical significance was tested using Mann-Whitney test. Results: The median age of patients with SA isolates was 66 years ; 56% were female. The most common localization was the lower leg (69% patients). All patients had an evident entry site, chronic ulcers (60%) being most common. At least one chronic risk factor was present in 86% patients, most commonly chronic venous insufficiency (CVI) (68%), cardiovascular disease (50%), diabetes mellitus (39%) and obesity (33%). 89% patients were febrile and over a third appeared severely unwell, including 6 of the 8 MRSA patients. Median C-reactive protein was 143 mg/L [84-171]) ; median leukocyte count was 12x109/mL [9, 9-14, 6]). Cefazolin was the preferred empirical antibiotic (36%) ; 36% of patients received a combination of two antibiotics empirically. Treatment was changed in 35% of cases, most frequently into vancomycin. Complications arose in 44% of the patients, the most common being abscess formation necessitating surgical intervention. Cardiovascular disease and CVI were the most common risk factors for complications as well as for recurrences of cellulitis. Median duration of fever was 3 days ; shorter for MSSA patients (2.5 days) than MRSA patients (5 days) (p=0.039). Duration of treatment was approximately the same for MSSA and MRSA (median 10 days, IQR 8-14). Median hospital stay was 11, 5 days, differing significantly between MSSA (10 days) versus MRSA patients (16 days) (p=0.0431). Conclusions: Almost half of our patients with SA cellulitis developed complications, presumably due to inadequate empirical therapy. Empirical treatment of cellulitis should include SA coverage, especially in patients with risk factors and open entry sites for infection.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA