Worse Outcomes With Acute Skin Plus Bloodstream Infections

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Patients with acute bacterial skin and skin structure infections and bloodstream infections were significantly older.
Patients with acute bacterial skin and skin structure infections and bloodstream infections were significantly older.

This article is part of Infectious Disease Advisor's in-depth coverage of IDWeek 2017™, which took place in San Diego, CA. Our staff will be reporting on the latest treatment advancements and research initiatives for skin infections. Check back regularly for highlights from IDWeek 2017.

According to recent research presented at IDWeek 2017 held October 4-8 in San Diego, California, bloodstream infections in patients with acute bacterial skin and skin structure infections were associated with poor outcomes. Risk factors for bloodstream infections included male gender, intravenous drug use, and renal failure, among others.

To evaluate the risk factors and outcomes associated with bloodstream infections secondary to acute bacterial skin and skin structure infections, 196 cases of Staphylococcus aureus bloodstream infections secondary to acute skin infections and 196 controls with acute skin infections alone were evaluated. Researchers compared in-hospital mortality, hospital length-of-stay, and 30-day reinfection in the 2 groups.

Risk factors for bloodstream infection included male gender (P =.008), intravenous drug use (P =.012), chronic renal failure (P =.002), prior hospitalization (P <.001), and systemic symptoms on hospital admission (eg, elevated temperature, white blood cell count, or acute renal failure; P <.001). After adjustment, male gender (odds ratio [OR] 1.85), acute renal failure (OR 2.08), intravenous drug use (OR 4.38), and prior hospitalization (OR 2.41) remained significant. 

Bloodstream infection was associated with in-hospital mortality (4.1% vs 0%; P <.001), longer mean length-of-stay (7.4 vs 2.7 days; P ≤.001), and 30-day reinfection (11.2% vs 4.1%; P =.006).

The study investigators concluded that "patients with [acute skin and skin structure infections with secondary bloodstream infections] had worse outcomes than those with [acute skin infections] alone. Factors associated with [secondary bloodstream infections], such as gender, IVDU [intravenous drug use], prior hospitalization, renal failure, and systemic signs/symptoms of infection may be used to identify patients at risk for [bloodstream infections secondary to acute skin infections]."


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Reference

Rybak MJ, Zasowski EJ, Trinh TD, Lagnf AM, Margaritis V, Mendelsohn AB. Risk factors and outcomes for bloodstream infections (BSI) among patients with acute bacterial skin and skin structure infections (ABSSSI). Presented at: IDWeek 2017; October 4-8, 2017; San Diego, California. Poster 259.

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