title: [Skin and soft-tissue infections in hospitalized patients: epidemiology, microbiological, clinical and prognostic factors].
abstract: BACKGROUND
  Skin and soft-tissue infections (SSTIs) are a frequent cause of consultation in emergence services, and complicated cases require hospitalization. However there are few data in our setting about the clinical characteristics of these infections.
  
  
  METHODS
  A retrospective review of hospital admitted patients with a diagnosis of folliculitis, cellulitis, erysipelas, abscesses, hidradenitis, furuncle, impetigo, fasciitis and Fournier's gangrene. Cases were extracted from the data base of diagnostic codes of the Archive and Clinical Documentation Department of Son Llàtzer Hospital from January 2002 to November 2011.
  
  
  RESULTS
  We studied 996 episodes in 841 hospitalized patients with any diagnosis of SSTIs. Cellulitis/erysipelas (66.7%) was the most frequently diagnosed condition, with 77% of all SSTIs being community acquired, and the majority of patients had comorbidities, mainly diabetes (33%) and heart failure (17.7%). The most frequent isolated microorganism was S.aureus (35.1%), in 19 (12.9%) cases with methicillin-resistance (MRSA), 84.2% of them were nosocomial or health care acquired. Monotherapy with aminopenicillin with clavulanic acid was the empiric treatment most frequently used (35.5%). New antibiotics for Gram-positive cocci (linezolid, daptomycin, and tigecycline) were used in patients with comorbidities that presented more complications (P<.001) and more risk of mortality (P=.001). During admission 10.9% of patients died, but only in 2.7% of them mortality was related to the SSTIs.
  
  
  CONCLUSIONS
  SSTIs attended most frequently in hospitalized patients are mainly cellulitis/erysipela, the majority community acquired. MRSA infections are mainly health care related. Use of new antibiotic for Gram-positive cocci was limited.
authors.affiliation: Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Son Llàtzer, Palma de Mallorca, España. Electronic address: manuelraya@hotmail.com.
authors.forename: Manuel
authors.initials: M
authors.lastname: Raya-Cruz
authors.affiliation: Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Ferullo
authors.affiliation: Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: María
authors.initials: M
authors.lastname: Arrizabalaga-Asenjo
authors.affiliation: Servicio de Dermatología, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nadal-Nadal
authors.affiliation: Servicio de Microbiología Clínica, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: María Paz
authors.initials: MP
authors.lastname: Díaz-Antolín
authors.affiliation: Servicio de Microbiología Clínica, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Margarita
authors.initials: M
authors.lastname: Garau-Colom
authors.affiliation: Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital Son Llàtzer, Palma de Mallorca, España.
authors.forename: Antonio
authors.initials: A
authors.lastname: Payeras-Cifre
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012874:Skin Diseases, Infectious / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D055815:Young Adult
keywords: Hospitalized patients; Infecciones de piel y partes blandas; Methicillin-resistant Staphylococcus aureus; Pacientes hospitalizados; Prevalence; Prevalencia; Prognosis; Pronóstico; Skin and soft tissue infections; Staphylococcus aureus resistente a la meticilina; Tratamiento; Treatment