Abstract：
UNASSIGNED: Despite the high prevalence and poor outcome of skin and soft tissue infections (SSTIs), very few studies from India have dealt with the subject. We planned a prospective study of inpatients with SSTIs to study the aetiology, clinical presentation (severity) and outcome of patients with SSTIs in our facility.
UNASSIGNED: Patients with SSTIs involving >5% body surface area (BSA) and/or systemic signs were admitted to the surgery department of a teaching tertiary level hospital in Delhi, India, and were clinically classified into cellulitis, necrotising soft tissue infections (NSTIs), pyomyositis, and abscess. Demographic and clinical variables such as: age; sex; occupation; history of trauma/insect or animal bites; duration of illness; presenting symptoms and signs; comorbid conditions; predisposing factors such as lymphoedema or venous disease; hospital course; treatment instituted; complications; hospital outcome; presence of crepitus, bullae, gangrene, muscle necrosis and compartment syndrome were recorded. The chief outcome parameters were death and length of hospital stay; others, such as abscess drainage, the need for plastic surgical procedures and amputations were also noted.
UNASSIGNED: Out of 250 patients enrolled in the study, 145 (58%) had NSTIs, 64 (26%) had abscesses, 15 (6%) had cellulitis and 26 (10%) had pyomyositis. Mortality was observed with NSTIs (27/145, 19%) and with pyomyositis (3/26, 11.5%). Factors affecting mortality by univariate analysis in the NSTI group were: abnormal pulse; hypotension; tachypnea; bullae; increased blood urea and serum creatinine; inotrope or ventilator support (all with p<0.001); local tenderness, gangrene, dialysis support and BSA (9.33±6.44 versus 5.12±3.62; p<0.05 for the last four). No factor was found to be significant on multivariate analysis. Variables associated with hospital stay >12 days were immunocompromise, pus discharge, ulceration or gangrene, and after interventions such as blood transfusion, drainage or skin grafting.
UNASSIGNED: High prevalence of NSTI and pyomyositis with high mortality was observed in our SSTI patients, often in immunocompetent young individuals. Epidemiological studies focused on virulent strains of Staphylococcus aureus may be required to identify the cause, since Staphylococcal toxins have been implicated in other infections.
UNASSIGNED: Patients with SSTIs involving >5% body surface area (BSA) and/or systemic signs were admitted to the surgery department of a teaching tertiary level hospital in Delhi, India, and were clinically classified into cellulitis, necrotising soft tissue infections (NSTIs), pyomyositis, and abscess. Demographic and clinical variables such as: age; sex; occupation; history of trauma/insect or animal bites; duration of illness; presenting symptoms and signs; comorbid conditions; predisposing factors such as lymphoedema or venous disease; hospital course; treatment instituted; complications; hospital outcome; presence of crepitus, bullae, gangrene, muscle necrosis and compartment syndrome were recorded. The chief outcome parameters were death and length of hospital stay; others, such as abscess drainage, the need for plastic surgical procedures and amputations were also noted.
UNASSIGNED: Out of 250 patients enrolled in the study, 145 (58%) had NSTIs, 64 (26%) had abscesses, 15 (6%) had cellulitis and 26 (10%) had pyomyositis. Mortality was observed with NSTIs (27/145, 19%) and with pyomyositis (3/26, 11.5%). Factors affecting mortality by univariate analysis in the NSTI group were: abnormal pulse; hypotension; tachypnea; bullae; increased blood urea and serum creatinine; inotrope or ventilator support (all with p<0.001); local tenderness, gangrene, dialysis support and BSA (9.33±6.44 versus 5.12±3.62; p<0.05 for the last four). No factor was found to be significant on multivariate analysis. Variables associated with hospital stay >12 days were immunocompromise, pus discharge, ulceration or gangrene, and after interventions such as blood transfusion, drainage or skin grafting.
UNASSIGNED: High prevalence of NSTI and pyomyositis with high mortality was observed in our SSTI patients, often in immunocompetent young individuals. Epidemiological studies focused on virulent strains of Staphylococcus aureus may be required to identify the cause, since Staphylococcal toxins have been implicated in other infections.
摘要：
■尽管皮肤和软组织感染（STTI）的患病率高，预后差，很少有来自印度的研究涉及到这个问题。我们计划了一项针对SSTIs住院患者的前瞻性研究，以研究其病因。我们设施中SSTIs患者的临床表现(严重程度)和结果。
患有>5％体表面积（BSA）和/或全身体征的SSTI患者被送往德里一家教学三级医院的外科部门，印度,临床上分为蜂窝织炎，坏死性软组织感染（NSTIs），化脓性肌炎,和脓肿。人口统计学和临床变量，如：年龄;性别;职业;外伤/昆虫或动物咬伤史;疾病持续时间;表现出症状和体征;合并症;诱发因素，如淋巴水肿或静脉疾病;住院过程;开始治疗;并发症;医院结果;是否存在偶发性，bullae,坏疽,记录肌肉坏死和骨筋膜室综合征.主要结果参数是死亡和住院时间；其他，如脓肿引流，还注意到需要整形外科手术和截肢。
■在参加研究的250名患者中，145（58%）有NSTI，64（26%）有脓肿，15（6％）患有蜂窝织炎，26（10％）患有化脓性肌炎。NSTIs（27/145，19％）和化脓性肌炎（3/26，11.5％）观察到死亡率。通过单因素分析影响NSTI组死亡率的因素是：脉搏异常；低血压；呼吸急促；大疱；血尿素和血清肌酐升高；抗张力或呼吸机支持（均p<0.001）；局部压痛，坏疽,透析支持和BSA（9.33±6.44对5.12±3.62；最后四次p<0.05）。在多变量分析中没有发现有意义的因素。与住院时间>12天相关的变量是免疫功能受损，脓液排出,溃疡或坏疽，在输血等干预措施之后，引流或植皮。
■在我们的SSTI患者中观察到NSTI和化脓性肌炎的高患病率和高死亡率，通常在有免疫能力的年轻人中。可能需要针对金黄色葡萄球菌毒力菌株的流行病学研究来确定原因，因为葡萄球菌毒素与其他感染有关。
患有>5％体表面积（BSA）和/或全身体征的SSTI患者被送往德里一家教学三级医院的外科部门，印度,临床上分为蜂窝织炎，坏死性软组织感染（NSTIs），化脓性肌炎,和脓肿。人口统计学和临床变量，如：年龄;性别;职业;外伤/昆虫或动物咬伤史;疾病持续时间;表现出症状和体征;合并症;诱发因素，如淋巴水肿或静脉疾病;住院过程;开始治疗;并发症;医院结果;是否存在偶发性，bullae,坏疽,记录肌肉坏死和骨筋膜室综合征.主要结果参数是死亡和住院时间；其他，如脓肿引流，还注意到需要整形外科手术和截肢。
■在参加研究的250名患者中，145（58%）有NSTI，64（26%）有脓肿，15（6％）患有蜂窝织炎，26（10％）患有化脓性肌炎。NSTIs（27/145，19％）和化脓性肌炎（3/26，11.5％）观察到死亡率。通过单因素分析影响NSTI组死亡率的因素是：脉搏异常；低血压；呼吸急促；大疱；血尿素和血清肌酐升高；抗张力或呼吸机支持（均p<0.001）；局部压痛，坏疽,透析支持和BSA（9.33±6.44对5.12±3.62；最后四次p<0.05）。在多变量分析中没有发现有意义的因素。与住院时间>12天相关的变量是免疫功能受损，脓液排出,溃疡或坏疽，在输血等干预措施之后，引流或植皮。
■在我们的SSTI患者中观察到NSTI和化脓性肌炎的高患病率和高死亡率，通常在有免疫能力的年轻人中。可能需要针对金黄色葡萄球菌毒力菌株的流行病学研究来确定原因，因为葡萄球菌毒素与其他感染有关。
