2368. Cellulitis in Adult Patients: a Large, Multicenter, Observational, Prospective Study of 606 Episodes and Analysis of the Factors Related to the Response to Treatment.
Session: Poster Abstract Session: Skin and Skin Structure Infection
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • Abst 68617 ID WKSF 2018.pdf (254.3 kB)
  • Background: Cellulitis is frequent cause of admission of adult patients to medical wards. Increasing prevalence of multiresistant microorganisms, comorbidities, predisposing factors and medical and surgical therapies might affect cellulitis response and recurrence rate.

    Methods: Prospective and observational study of 606 adult patients with cellulitis admitted to the Internal Medicine wards of several Spanish hospitals. Comorbidities, microbiological, clinical, diagnostic, treatment (surgical and antibiotic) data were analyzed according to the cellulitis response. Good response implied cure. Poor response implied failure to cure or initial cure but relapse within 30 days of hospital discharge

    Results: Mean age was 63.3 years and 51.8% were men. Poor responses were significantly associated with age, previous episodes of cellulitis, prior wounds and skin lesions, venous insufficiency, lymphedema, immunosuppression and lower limbs involvement No differences in ESR or CRP blood levels, leukocyte counts, pus or blood cultures positivity or microbiological or imaging aspects were observed in those with good or poor responses. Regarding antimicrobials, no differences in previous exposition before hospital admission, treatment with single or more than one antibiotic, antibiotic switch, days on antimicrobials or surgical treatment were observed regarding good or poor cellulitis response. Prior episodes of cellulitis (P=0.0001), venous insufficiency (P=0.004), immunosuppression (P=0.03), and development of sepsis (P=0.05) were associated with poor treatment responses, and non-surgical trauma (P=0.015) with good responses, in the multivariate analysis.

    Conclusion: Prior episodes of cellulitis, non-surgical trauma, venous insufficiency, sepsis and immunosuppression were independently associated with treatment response to cellulitis, but not the causing microorganism, the number of antimicrobials administered or its duration.

    Julio Collazos, MD, PhD1, Belen De La Fuente, MD, PhD2, Alicia Garcia, MD3, Helena Gomez, GOMEZ3, Candela Menendez, MD3, Hector Enriquez, MD4, Paula Sanchez, MD5, Maria Alonso, MD4, Ian Lopez-Cruz, MD6, Manuel Martin-Regidor, MD7, Ana Martinez-Alonso, MD7, Jose Guerra, MD, PhD7, Arturo Artero, MD, PhD8, Marino Blanes, MD, PhD9, Javier De La Fuente, MD, PhD4 and Victor Asensi, MD, PhD10, (1)Infectious Diseases, HOSPITAL DE GALDACANO, GALDACANO, Spain, (2)Medicine, HOSPITAL DE CABUEƑES, GIJON, Spain, (3)Medicine, HOSPITAL UNIVERSITARIO CENTRAL DE ASTURIAS, OVIEDO UNIVERSITY SCH.MEDICINE, OVIEDO, Spain, (4)Medicine, HOSPITAL DE POVISA, VIGO, Spain, (5)HOSPITAL DE POVISA, VIGO, Spain, (6)Medicine, HOSPITAL DR PESET, VALENCIA, Spain, (7)Medicine, HOSPITAL DE LEON, LEON, Spain, (8)Medicine and Infectious Diseases, HOSPITAL DR PESET, VALENCIA, Spain, (9)Infectious Diseases, HOSPITAL LA FE, VALENCIA, Spain, (10)Medicine and Infectious Diseases, HOSPITAL UNIVERSITARIO CENTRAL DE ASTURIAS, OVIEDO UNIVERSITY SCH.MEDICINE, OVIEDO, Spain

    Disclosures:

    J. Collazos, None

    B. De La Fuente, None

    A. Garcia, None

    H. Gomez, None

    C. Menendez, None

    H. Enriquez, None

    P. Sanchez, None

    M. Alonso, None

    I. Lopez-Cruz, None

    M. Martin-Regidor, None

    A. Martinez-Alonso, None

    J. Guerra, None

    A. Artero, None

    M. Blanes, None

    J. De La Fuente, None

    V. Asensi, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.