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Factors associated with blood culture positivity in patients with complicated skin and skin structure infection—a population-based study

Journal article
Authors M. Halavaara
I. H. Jääskeläinen
Lars Hagberg
A. Järvinen
Published in European Journal of Clinical Microbiology and Infectious Diseases
ISSN 0934-9723
Publication year 2019
Published at Institute of Biomedicine, Department of Infectious Medicine
Language en
Keywords Abscess, Bacteremia, Bloodstream infection, C-reactive protein, Cellulitis, Skin and soft tissue infection
Subject categories Microbiology in the medical area


Skin and skin structure infection (SSSI) is classified as complicated (cSSSI) if it involves deep subcutaneous tissue or requires surgery. Factors associated with blood culture sampling and bacteremia have not been established in patients with cSSSI. Moreover, the benefit of information acquired from positive blood culture is unknown. The aim of this study was to address these important issues. In this retrospective population-based study from two Nordic cities, a total of 460 patients with cSSSI were included. Blood cultures were drawn from 258 (56.1%) patients and they were positive in 61 (23.6%) of them. Factors found to be associated with more blood culture sampling in multivariate analysis were diabetes, duration of symptoms shorter than 2 days and higher C-reactive protein (CRP) level. Whereas factors associated with less frequent blood culture sampling were peripheral vascular disease and a surgical wound infection. In patients from whom blood cultures were taken, alcohol abuse was the only factor associated with culture positivity, as CRP level was not. Patients with a positive blood culture had antibiotic streamlining more often than non-bacteremic patients. A high rate of blood culture positivity in patients with cSSSI was observed. Factors related to more frequent blood culture sampling were different from those associated with a positive culture. © 2019, The Author(s).

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