Severe and complicated soft tissue infections: a single-centre case series

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Health Economics

Background:

• Complicated skin and soft tissue infections (cSSTIs) pose a significant clinical challenge.
• Understanding the demographic, clinical, and economic aspects of cSSTIs is essential for optimizing patient care.
• High rates of multidrug-resistant organisms complicate treatment strategies.

Purpose of the Study:

• To characterize the demographic and clinical profiles of patients with cSSTIs.
• To identify laboratory findings and risk factors associated with cSSTI outcomes.
• To assess the economic burden of cSSTIs, including treatment costs and mortality rates.

Main Methods:

• Retrospective analysis of patients diagnosed with cSSTIs between January 2017 and December 2019.
• Evaluation of demographic data, clinical presentation, laboratory results, and treatment interventions.
• Statistical analysis to determine factors influencing mortality and treatment costs.

Main Results:

• The study included 24 patients; 58% were female, with a median age of 53. Diabetes was the most common comorbidity (54%).
• Sepsis (75%) and high Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) scores (70%) were prevalent on admission. Multidrug-resistant Gram-negative bacteria were found in 50% of cases.
• Mortality rate was 29%. Significant predictors of non-survival included confusion, Gram-negative infections, hyponatremia, and intensive care unit (ICU) admission. Hyponatremia was an independent risk factor for mortality (p=0.048). Treatment costs were substantially higher for non-survivors ($9453 USD) compared to survivors ($1536 USD).

Conclusions:

• Empirical antibacterial and surgical treatment strategies for cSSTIs should consider local resistance patterns.
• Sepsis, high LRINEC scores, and hyponatremia are critical predictors of mortality in cSSTI patients.
• Addressing hyponatremia and early recognition of sepsis are vital for improving outcomes and reducing the economic burden of cSSTIs.