Identifying patients with acute bacterial skin and skin structure infection who need blood cultures

  • Giusy Tiseo
  • Antonino Mazzone
  • Marco FalconeEmail author

In this issue of Internal and Emergency Medicine, Chang and coworkers identify some factors associated with bacteremia in patients with acute bacterial skin and skin structure infections (ABSSSIs) [1]. The role of blood cultures in ABSSSIs remains controversial for several reasons. Patients with skin infections rarely have bacteremia: a systematic review of bacteremia episodes in patients with cellulitis and erysipelas shows that blood cultures are positive in only 7.9% and 4.6% of cases, respectively [2]. Other reports show that the incidence of bacteremia in patients with uncomplicated cellulitis is 4.8%, and are due to Streptococcus spp and Staphylococcus aureus, as expected considering the classical microbiology of non-purulent skin infection [3, 4]. Among patients needing hospitalization, methicillin-resistant Staphylococcus aureus (MRSA) appears as a leading pathogen, and an increasing prevalence of community-acquired MRSA has been reported in the last decade [5, 6]. Thus,...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

The data provided are part of an observational study. All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

The data provided are part of an observational study. Approval of the study protocol was obtained from the institutional review boards at each hospital, which waived the requirement for obtaining informed consent.


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Copyright information

© Società Italiana di Medicina Interna (SIMI) 2019

Authors and Affiliations

  1. 1.Internal Medicine SpecialistRomeItaly
  2. 2.Internal Medicine WardLegnanoItaly
  3. 3.Division of Infectious Diseases, Department of Clinical and Experimental MedicineUniversity of PisaPisaItaly

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