Bloodstream infections common among epidermal necrolysis patients
Bloodstream infections (BSIs) are common among patients with epidermal necrolysis (EN) and are mostly caused by Staphylococcus aureus and Pseudomonas aeruginosa, a recent study has found. Skin cultures may help predict such infections.
Researchers performed a retrospective, single-centre observational study of 98 patients (median age, 49.6 years; 56 percent female) who had acute-phase EN with body surface area (BSA) involvement ≥10 percent. Information about blood and skin cultures, as well as the time and severity of BSI were collected and included in the analysis.
Almost half (46.9 percent; n=46) experienced at least one BSI episode after a median of 7 days after admission. A total of 85 cases were reported, and the incidence rate was 33.3 BSIs per 1,000 days of hospitalization per patient. More than half (52.2 percent; n=24) of the BSI patients experienced septic shock, while 26 percent (n=12) died.
S. aureus and P. aeruginosa accounted for majority of the positive blood cultures, each detected in 36.9 percent of the samples. Almost a fourth (23.9 percent) of blood cultures were polymicrobial.
Similarly, S. aureus (38 percent) was the most common infectious agent during the first skin culture, while P. aeruginosa (79 percent) dominated the third skin cultures. In 71.1 percent of the cases, bacteria isolated from the skin cultures corresponded with the bacteria responsible for the BSI.
In terms of diagnostic performance, skin cultures of S. aureus had a sensitivity of 88.2 percent and a specificity of 60.7 percent. Cultures of P. aeruginosa, on the other hand, had corresponding values of 75.0 percent and 58.4 percent.