Microbiologic Analysis of Hand Infections: A Prospective Study.

Area of Science:

• Infectious Diseases
• Microbiology
• Emergency Medicine

Background:

• Hand infections are frequent in emergency departments.
• Staphylococcus aureus is a common cause of both hand and bloodstream infections.
• Early detection of bacteremia is key for managing hand infections.

Purpose of the Study:

• To determine the frequency and impact of bacteremia in patients with acute hand infections.
• To enhance microbiologic diagnostic strategies for hand infections.
• To correlate bacteremia with clinical severity and treatment outcomes.

Main Methods:

• Prospective study of 90 patients with acute hand infections without prior antibiotic treatment.
• Pre-operative blood cultures and tissue sample analysis.
• Broad-spectrum bacterial 16S ribosomal RNA (rRNA) gene polymerase chain reaction (PCR) for culture-negative samples.

Main Results:

• Six patients (6.6%) presented with bacteremia, primarily following animal bites and intra-articular empyema.
• Bacteremic patients had more surgeries, longer hospital stays, higher CRP levels, and were older.
• 16S rRNA gene PCR identified pathogens in 3 of 14 culture-negative cases (21.4%).

Conclusions:

• Pre-operative blood cultures are vital for identifying bacteremia as a marker of severity in hand infections.
• Blood cultures are particularly indicated after deep animal bites and joint empyema.
• 16S rRNA gene PCR is a valuable tool for diagnosing pathogens in culture-negative hand infection samples.