This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
nan wang
Jilin University First Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5954-5457
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
For complicated skin and soft tissue infections (cSSTIs), inappropriate initial anti-infective treatment often leads to treatment failure. The microbial distribution in patients with extremities’ cSSTIs has been rarely reported. Moreover, whether gram-negative bacteria (GNB) should be covered in addition to gram-positive bacteria (GPB) has been always a difficult issue in the treatment of cSSTIs.
Methods
We retrospectively analyzed the microbial distribution and antibiotic susceptibility in 149 hospitalized patients with extremities’ SSTIs, and discussed the risk factors of extremities’ cSSTIs caused by GNB.
Results
188 strains of pathogens were isolated, including 113 strains of GPB (64.9%), 61 strains of GNB (32.4%), and 5 strains of fungi (2.7%). Diabetes mellitus (OR=3.606, P =0.034), SSTI severity [moderate infection (OR=19.499, P <0.0001), severe infection (OR=20.114, P <0.0001)], and necrotizing infection (OR=6.064, P <0.0001) were risk factors of extremities’ cSSTIs caused by GNB. For patients with risk factors, ceftazidime, cefepime, piperacillin/tazobactam and carbapenems could be empirical anti-infective agents.
Conclusions
The results of our study showed that the most common bacteria identified in cSSTIs of the extremities were GPB. For patients with risk factors of extremities’ cSSTIs caused by GNB, the coverage of GNB should be taken into account.
Keywords
Complicated skin and soft tissue infection, Extremity, Microbial distribution, Antibiotic susceptibility, Gram-negative bacteria
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
nan wang
Jilin University First Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-5954-5457
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 05 Jun, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
For complicated skin and soft tissue infections (cSSTIs), inappropriate initial anti-infective treatment often leads to treatment failure. The microbial distribution in patients with extremities’ cSSTIs has been rarely reported. Moreover, whether gram-negative bacteria (GNB) should be covered in addition to gram-positive bacteria (GPB) has been always a difficult issue in the treatment of cSSTIs.
Methods
We retrospectively analyzed the microbial distribution and antibiotic susceptibility in 149 hospitalized patients with extremities’ SSTIs, and discussed the risk factors of extremities’ cSSTIs caused by GNB.
Results
188 strains of pathogens were isolated, including 113 strains of GPB (64.9%), 61 strains of GNB (32.4%), and 5 strains of fungi (2.7%). Diabetes mellitus (OR=3.606, P =0.034), SSTI severity [moderate infection (OR=19.499, P <0.0001), severe infection (OR=20.114, P <0.0001)], and necrotizing infection (OR=6.064, P <0.0001) were risk factors of extremities’ cSSTIs caused by GNB. For patients with risk factors, ceftazidime, cefepime, piperacillin/tazobactam and carbapenems could be empirical anti-infective agents.
Conclusions
The results of our study showed that the most common bacteria identified in cSSTIs of the extremities were GPB. For patients with risk factors of extremities’ cSSTIs caused by GNB, the coverage of GNB should be taken into account.
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