The Role of Acute-Phase Reactants in Determining Bacteremia and Evaluation of Diagnostic Benefits of Cultures in Cellulitis Cases

Abstract

INTRODUCTION[|]This study aims to investigate the relationship between bacteremia and the level of acute phase reactants in cellulite cases and to evaluate the value of blood culture and tissue/wound/abscess cultures in determining causal microorganism.[¤]METHODS[|]The adult patients were included in this study, who were hospitalized with a diagnosis of cellulitis between January 1, 2015, and December 31, 2016. Patients' medical records revealed from computer based hospital system, retrospectively. Patients with diabetic foot infections, decubitus infections, cellulite accompanying shingles and other concomitant system infections were excluded from this study. Before antibiotic treatment, patient's body temperature, leukocyte count, c reactive protein level, erythrocyte sedimentation rate, culture results, antibiotic treatment before hospitalization, empirical antibiotic treatment in hospital, treatment duration, comorbidities and clinical response data were collected.[¤]RESULTS[|]There were 194 patients in this study. Blood cultures collected from 143 patients before antibiotic treatment. Nine of 143 (6.3%) patient's blood cultures were positive. On the other hand, results of the tissue/wound cultures were positive in 17 of the 35 cases (48.6%). Mean white blood cell count at the first admission was 13.9x103/mm3 in non-bacteremic group and 15.2x103/mm3 in bacteremic group. Mean C-reactive protein level at the first admission was 148 mg/L in non-bacteremic group and 164 mg/L in bacteremic group. There was no statistical significance between these two acute phase marker and bacteremia in cellulitis cases. However, mean erythrocyte sedimentation rate was 92 vs 56.5 mm/h respectively in bacteremic and non-bacteremic patient (p=0.03).[¤]DISCUSSION AND CONCLUSION[|]In the cases of cellulitis, blood culture did not provide sufficient clinical benefit for the etiology even the presence of fever. It was concluded that taking culture samples from infection site, such as abscess, wound and tissue culture, would be more useful for identification of the etiologic agent.[¤]

Keywords

• acute phase reactants
• bacteremia; cellulitis; soft tissue infection; culture.