Table 1 Risk factors associated with treatment failure among patients with community-associated S. aureus skin and soft tissue infections
Characteristic | Overall, n = 106 | No failure, n = 84 | Treatment failure, n = 22 | OR (95% CI) | p | aOR (95% CI) | p |
|---|---|---|---|---|---|---|---|
Mean age, years (±SD) | 41 (±14) | 40 (±13) | 45 (±13) | 0.15 | |||
Gender | |||||||
Male | 53 (50%) | 44 (52%) | 9 (41%) | 0.63 (0.24–1.63) | 0.34 | ||
Race/ethnicity | |||||||
Black | 8 (8%) | 4 (5%) | 4 (18%) | 4.44 (1.02–19.47) | 0.03 | ||
Hispanic | 78 (74%) | 64 (76%) | 14 (64%) | 0.547 (0.20–1.49) | 0.23 | ||
Diabetes | 28 (26%) | 21 (25%) | 7 (32%) | 1.40 (0.50–3.89) | 0.52 | ||
Obese (BMI ≥ 30)b | 50 (54%) | 38 (50%) | 12 (71%) | 2.40 (0.77–7.48) | 0.12 | ||
Weight ≥110 kg | 19 (20%) | 12 (15%) | 7 (37%) | 3.21 (1.05–9.80) | 0.04 | ||
Chronic non-infectious skin disorder | 1 (1%) | 1 (1%) | 0 | 0.99 (0.97–1.01) | 1.00 | ||
Immunosuppressed at time of visit | 2 (2%) | 2 (2%) | 0 | 0.98 (0.94–1.01) | 1.00 | ||
Provides healthcare to others | 2 (2%) | 1 (1%) | 0 | 0.99 (0.97–1.01) | 1.00 | ||
MRSA phenotype | 68 (65%) | 55 (66%) | 13 (59%) | 0.87 (0.49–1.56) | 0.65 | 0.42 (0.12–1.42) | 0.16 |
MDR | 29 (27%) | 10 (12%) | 19 (86%) | 2.85 (1.07–7.62) | 0.03 | ||
Prior SSTI | 35 (33%) | 27 (32%) | 8 (36%) | 1.21 (0.45–3.20) | 0.71 | ||
Prior antibiotic history | 16 (15%) | 11 (13%) | 5 (23%) | 1.95 (0.60–6.36) | 0.32 | ||
Duration of infection prior to visit ≥7 days | 48 (48%) | 32 (40%) | 16 (76%) | 4.80 (1.59–14.41) | <0.01 | 6.02 (1.74–20.87) | <0.01 |
Severity | |||||||
Largest diameter ≥5 cm | 49 (48%) | 34 (42%) | 15 (71%) | 3.53 (1.24–10.02) | 0.01 | 5.25 (1.58–17.42) | <0.01 |
Lesion area ≥25 cm2 | 37 (35%) | 24 (29%) | 13 (59%) | 3.55 (1.34–9.39) | 0.01 | ||
Infection characteristics | |||||||
Erythema | 78 (74%) | 61 (74%) | 17 (77%) | 1.23 (0.40–3.72) | 0.72 | ||
Drainage | 56 (53%) | 45 (54%) | 11 (50%) | 0.84 (0.33–2.16) | 0.72 | ||
Ulceration | 30 (29%) | 22 (27%) | 8 (36%) | 1.58 (0.59–4.29) | 0.43 | ||
Abscess | 76 (72%) | 56 (67%) | 20 (91%) | 4.82 (1.05–22.14) | 0.03 | ||
Location | |||||||
Lower extremity | 35 (33%) | 26 (31%) | 9 (41%) | 1.54 (0.59–4.06) | 0.38 | ||
Head/neck/face | 11 (10%) | 10 (12%) | 1 (5%) | 0.35 (0.40–2.91) | 0.45* | ||
Trunk | 24 (23%) | 17 (20%) | 7 (32%) | 1.84 (0.65–5.22) | 0.26* | ||
Axilla | 13 (12%) | 11 (13%) | 2 (9%) | 0.66 (0.14–3.24) | 0.61* | ||
Upper extremity | 6 (6%) | 5 (6%) | 1 (5%) | 0.75 (0.08–6.79) | 1.00* | ||
Groin/buttock | 17 (16%) | 14 (17%) | 3 (14%) | 0.79 (0.21–3.03) | 1.00* | ||
Treatment | |||||||
I&D only | 4 (4%) | 3 (4%) | 1 (5%) | 1.01 (0.91–1.12) | 1.00 | ||
I&D + antibiotics | 57 (59%) | 43 (51%) | 14 (64%) | 1.30 (0.68–2.51) | 0.41 | ||
Antibiotics only | 32 (33%) | 27 (36%) | 5 (24%) | 0.84 (0.63–1.13) | 0.29 | ||
Antibiotics | |||||||
Trimethoprim–sulfamethoxazole | 81 (76%) | 65 (77%) | 16 (73%) | 0.78 (0.27–2.27) | 0.65 | ||
Doxycycline | 12 (11%) | 9 (11%) | 3 (14%) | 1.32 (0.32–5.34) | 0.71 | ||
Clindamycin | 7 (7%) | 5 (6%) | 2 (9%) | 1.58 (0.26–8.75) | 0.63 | ||
Cephalexin | 9 (9%) | 7 (8%) | 2 (9%) | 1.10 (0.21–5.71) | 1.00 | ||
Discordant therapy | 5 (5%) | 3 (4%) | 2 (11%) | 2.82 (0.44–18.24) | 0.26 | ||