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

被引：10

作者：

Collazos, J. ^{[1
]}

de la Fuente, B. ^{[2
]}

de la Fuente, J. ^{[3
]}

Garcia, A. ^{[4
]}

Gomez, H. ^{[4
]}

Menendez, C. ^{[4
]}

Enriquez, H. ^{[3
]}

Sanchez, P. ^{[3
]}

Alonso, M. ^{[3
]}

Lopez-Cruz, I. ^{[5
]}

Martin-Regidor, M. ^{[6
]}

Martinez-Alonso, A. ^{[6
]}

Guerra, J. ^{[6
]}

Artero, A. ^{[5
]}

Blanes, M. ^{[7
]}

Asensi, V. ^{[4
,8
]}

机构：

[1] Hosp Galdacano, Infect Dis Unit, Vizcaya, Spain

[2] Hosp Cabuenes, Infect Dis Unit, Gijon, Spain

[3] Hosp Povisa, Internal Med Serv, Vigo, Spain

[4] Hosp Univ Cent Asturias, Infect Dis Unit, Oviedo, Spain

[5] Hosp Dr Peset, Internal Med Serv, Valencia, Spain

[6] Complejo Hosp Leon, Internal Med Serv, Leon, Spain

[7] Hosp La Fe, Infect Dis Unit, Valencia, Spain

[8] Inst Invest Sanit Principado Asturias ISPA, Grp Translat Res Infect Dis, Oviedo, Spain

来源：

BMC INFECTIOUS DISEASES | 2020年 / 20卷 / 01期

关键词：

Cellulitis; Sepsis; Outcome; Antibiotics; Surgery; SOFT-TISSUE INFECTIONS; BLOOD CULTURES; SKIN; GUIDELINES; BACTEREMIA; DEFINITIONS; MANAGEMENT; OUTCOMES;

D O I：

10.1186/s12879-020-4915-1

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

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.

引用

页数：12

共 29 条

[1] Blood cultures in the evaluation of uncomplicated cellulitis [J].