Impact of health care–associated community-onset cellulitis in Korea: a multicenter study
We conducted a multicenter study to determine the clinical and microbiological characteristics of health care–associated (HCA) cellulitis in Korea. We retrospectively reviewed the medical records of patients who had been diagnosed with community-onset cellulitis. Of the 2208 cellulitis patients, 232 (10.5%) had HCA cellulitis, 1243 (56.3%) patients were hospitalized, and 15 (0.7%) died in hospital. Compared with community-acquired (CA) cellulitis, patients with HCA cellulitis were older and more frequently presented with comorbidity and septic shock. A total of 355 microorganisms were isolated from 314 patients (14.2%). Staphylococcus aureus (134 isolates) was the most common organism, followed by Streptococcus spp. (86 isolates) and Gram-negative fermenters (58 isolates). Methicillin-resistant S. aureus (MRSA) accounted for 29.1% (39/134) of S. aureus infections. None of the Gram-negative fermenters were resistant to carbapenem. The antibiotic susceptibility pattern of isolated microorganisms was not different between HCA and CA cellulitis. In patients with HCA cellulitis, S. aureus (11.2% [26/232] vs. 5.5% [108/1976], p = 0.001), including MRSA (4.3% [10/232] vs. 1.5% [29/1976], p = 0.003) and Gram-negative fermenters (6.0% [14/232] vs. 2.3% [44/1976], p = 0.002), were more common causative organisms than in CA-cellulitis patients. Age ≥ 65 years, septic shock, and HCA infection were statistically significant factors associated with in-hospital mortality.
KeywordsCellulitis Health care–associated infection Staphylococcus aureus
PSY contributed to the study design, data gathering, analyses, and interpretation and wrote the first draft of the manuscript. KT, JJ, CSH, YSN, HHL, KYK, PSY, SHE, PKH, COH, and CSH contributed to data analyses and data interpretation, and critiqued the report. KYG contributed to the study design, data interpretation, and review and critiqued the report. KYG had full access to all data and made the final decision to submit for publication.
Compliance with ethical standards
Conflict of interest
The author declare that they have no conflict of interest.
This work was approved by the Institutional Review Board of each hospital, and informed consent was waived since this was a retrospective study without intervention that did not involve extra clinical specimens.
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