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Indian Journal of Dermatology, Venereology and Leprology
Medknow Publications on behalf of The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL)
ISSN: 0378-6323
EISSN: 0378-6323
Vol. 77, No. 2, 2011, pp. 141-147
Bioline Code: dv11042
Full paper language: English
Document type: Research Article
Document available free of charge

Indian Journal of Dermatology, Venereology and Leprology, Vol. 77, No. 2, 2011, pp. 141-147

 en Clinical and bacteriological profile and outcome of sepsis in dermatology ward in tertiary care center in New Delhi
Asati, D.P.; Sharma, V.K.; Khandpur, S.; Khilnani, G.C. & Kapil, A.

Abstract

Background: There is paucity of data regarding the clinical and bacteriological profile of sepsis in dermatology in-patients.
Aims: To study the frequency, etiology, and outcome of sepsis dermatology in-patients.
Methods: The study was conducted in a 30-bedded dermatology ward of a tertiary care center. Sepsis was defined by presence of ≥2 SIRS (systemic inflammatory response syndrome) criteria along with evidence of infection (clinically obvious/culture proven infection of skin or internal organs). Patients were also assessed for known (common) risk factors of sepsis. In suspected sepsis patients, at least two samples of blood cultures by venepuncture were taken. Pus, skin swab, urine, and sputum samples were also collected for culture as needed with avoidance of contamination.
Results: Among 860 admitted patients studied from November 2004 to July 2006, 103 (12%) fulfilled SIRS criteria. Of these, 63 had nonsepsis causes of SIRS positivity, while 40 (4.65%) had sepsis. Majority of the sepsis patient had vesicobullous diseases (42.5%), erythroderma (25%), toxic epidermal necrolysis (TEN) (22.5%). Severe sepsis developed in 17 (42.5%) patients, while 15 (37.5%) died. Methicillin-resistant Staphylococcus aureus check for this species in other resources (MRSA) was the commonest organism isolated (99; 25.9%) in all culture specimens followed by Acinetobacter spp. (52; 13.6%), Pseudomonas check for this species in other resources spp. (40; 10.5%), Methicillin-sensitive S. aureus (MSSA: 33; 8.7%), and Klebsiella spp. (22; 5.8%). Various risk factors affecting mortality and sensitivity patterns for various isolates were also analyzed.
Conclusion: Sepsis occurred in 40 (4.65%) inpatients in dermatology ward. The frequency of sepsis was highest in TEN (90%), followed by drug-induced maculopapular rash (20.0%), erythroderma (17.5%), and vesicobullous diseases (8.5%). MRSA, acinetobacter, pseudomonas, MSSA, and Klebsiella were important etiological agents involved in sepsis in dermatology in-patients.

Keywords
Sepsis, acinetobacter, antibiotic sensitivity, mortality, methicillin-resistantStaphylococcus aureus

 
© Copyright 2011 Indian Journal of Dermatology, Venereology, and Leprology.
Alternative site location: http://www.ijdvl.com

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