背景:涉及体表面积(BSA)≥10%的表皮坏死松解症(EN)通常会并发细菌感染。
目的:我们试图描述涉及BSA≥10%的EN中血流感染(BSIs)的流行病学以及皮肤培养物的诊断性能,以预测从BSIs中分离出的病原体。
方法:这项回顾性单中心观察性研究于2009年至2017年进行。包括所有在急性期转诊的涉及BSA≥10%的EN患者。收集所有临床和细菌学相关数据(血液和皮肤培养结果,number,以及BSI的严重程度和时间)。灵敏度,特异性,并研究了皮肤培养物的预测值和细菌接种物的影响。
结果:在98名患者中,46例(46.9%)在住院期间发生≥1次BSI(BSI由金黄色葡萄球菌[n=17,36.9%]和铜绿假单胞菌[n=17,36.9%]引起)。32例(71.1%)皮肤培养与血培养结果一致。金黄色葡萄球菌的阳性预测值和阴性预测值分别为57.7%和89.4%,铜绿假单胞菌的阳性预测值分别为50.0%和80.9%。分别。BSI随金黄色葡萄球菌皮肤接种物的增加而增加。
结论:这是一个回顾性的单中心设计,BSI总数较低。
结论:金黄色葡萄球菌和铜绿假单胞菌的皮肤培养可能有助于预测BSIs涉及的病原体。
BACKGROUND: Epidermal necrolysis (EN) involving ≥10% of the body surface area (BSA) is often complicated by bacterial infections.
OBJECTIVE: We sought to describe the epidemiology of bloodstream infections (BSIs) in EN involving a BSA ≥10% and the diagnostic performances of skin cultures for predicting the pathogen(s) isolated from BSIs.
METHODS: This retrospective single-center observational study was conducted between 2009 and 2017. All patients referred at the acute phase for EN involving a BSA ≥10% were included. All clinical and bacteriologically relevant data were collected (blood and skin cultures results, number, and severity and time of BSI). Sensitivity, specificity, and predictive values of skin cultures and impact of the bacterial inoculum were investigated.
RESULTS: Of 98 patients, 46 (46.9%) had ≥1 BSI episode during the hospital stay (BSIs were caused by Staphylococcus aureus [n = 17, 36.9%] and Pseudomonas aeruginosa [n = 17, 36.9%]). Skin cultures were concordant with blood cultures in 32 cases (71.1%). The positive and negative predictive values were 57.7% and 89.4% for S aureus and 50.0% and 80.9% for P aeruginosa, respectively. BSI increased with cutaneous inoculum of S aureus.
CONCLUSIONS: This was a retrospective single-center design with a low total number of BSIs.
CONCLUSIONS: Skin cultures for S aureus and P aeruginosa may help predict the pathogens involved in BSIs.