CELLULITIS :SPECTRUM OF THE DISEASE IN A TERTIARY CARE HOSPITAL
Journal Title: GJRA-Global Journal For Research Analysis - Year 2019, Vol 8, Issue 6
Abstract
Background: Cellulitis is a non suppurative, invasive infection of tissues, which is usually related to the point of injury. It is characterized by an expanding area of erythematous, edematous tissue that is painful in association with fever , malaise, leucocytosis.It is typically caused by organisms such as beta hemolytic streptococci, staphylococci and Clostridium perfringens. Approximately 2% of total surgery OPD visits are cellulitis patients. Methods: Data was taken from October 2017 to September 2018 from the department of surgery and from the department of Microbiology, Assam Medical College. Data was analyzed with respect to age, sex, presentation, associated comorbidities, mode of onset, body site distribution, progression of disease, organism isolated from microbiological culture and their antibiotic sensitivity, adjuvant treatment provided, duration of hospital stay and outcome. Results: Total 112 patients were included in the study. Chronic liver disease was associated with 36 cases, followed by obesity in 29 cases. Blood culture was positive in 4 cases. Most common organism isolated was klebsiella pneumonia (22 cases) and methicillin resistant staphylococcus aureus (15 cases). Most sensitive antibiotic for gram negative bacilli was tigecycline and colistin. Most sensitive antibiotic for gram positive cocci were linezolid, vancomycin and ooxacin. Most common empirical antibiotic given was linezolid followed by piperacillin with tazobactum. Discussion: Recent emergence of community acquired MRSA, along with gram negative organisms like klebsiella esp. ESBL(extended spectrum beta lactamase)+ve klebsiella pneumoniae sensitive to higher end antibiotic like colistin, tigecycline causes more concern. Antibiotic therapy is recommended depending upon local practice and resistance rate in consultation with medical microbiologist. Addressing of non-antibiotic factors such as limb elevation, wound dressing & of comorbidities should be considered as integrated part of clinical management of cellulitis.
Authors and Affiliations
Konwar Uttam, Hazarika Basob Jyoti
Keywords
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