Cellulitis, a frequent cause of admission of adult patients to medical wards, occasionally evolves to sepsis. In this study we analyze the factors related to sepsis development. Prospective and observational study of 606 adult patients with cellulitis admitted to several Spanish hospitals. Comorbidities, microbiological, clinical, lab, diagnostic, and treatment data were analyzed. Sepsis was diagnosed according to the criteria of the 2016 International Sepsis Definitions Conference. Multiple logistic regression modelling was performed to determine the variables independently associated with sepsis development. Mean age was 63.4 years and 51.8% were men. Overall 65 (10.7%) patients developed sepsis, 7 (10.8%) of whom died, but only 4 (6.2%) due to cellulitis. Drawing of blood (P < 0.0001) or any (P < 0.0001) culture, and identification of the agent (P = 0.005) were more likely among patients with sepsis. These patients had also a longer duration of symptoms (P = 0.04), higher temperature (P = 0.03), more extensive cellulitis (P = 0.02), higher leukocyte (P < 0.0001) and neutrophil (P < 0.0001) counts, serum creatinine (P = 0.001), and CRP (P = 0.008) than patients without sepsis. Regarding therapy, patients with sepsis were more likely to undergo changes in the initial antimicrobial regimen (P < 0.0001), received more antimicrobials (P < 0.0001), received longer intravenous treatment (P = 0.03), and underwent surgery more commonly (P = 0.01) than patients without sepsis. Leukocyte counts (P = 0.002), serum creatinine (P = 0.003), drawing of blood cultures (P = 0.004), change of the initial antimicrobial regimen (P = 0.007) and length of cellulitis (P = 0.009) were independently associated with sepsis development in the multivariate analysis. Increased blood leukocytes and serum creatinine, blood culture drawn, modification of the initial antimicrobial regimen, and maximum length of cellulitis were associated with sepsis in these patients.

中文翻译：

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606名西班牙成人蜂窝织炎患者与败血症发生相关的因素。

蜂窝织炎是成年患者入住医疗病房的常见原因，偶尔会发展为败血症。在这项研究中，我们分析了败血症发生的相关因素。前瞻性和观察性研究纳入西班牙几家医院的606名成人蜂窝织炎患者。分析了合并症，微生物学，临床，实验室，诊断和治疗数据。脓毒症是根据2016年国际脓毒症定义会议的标准诊断的。进行多元逻辑回归建模以确定与脓毒症发展独立相关的变量。平均年龄为63.4岁，男性为51.8％。共有65名（10.7％）患者发展为败血症，其中7名（10.8％）死于蜂窝织炎，但只有4名（6.2％）。抽血（P <0.0001）或任何（P <0.0001）培养物，败血症患者更容易发现和鉴定该药物（P = 0.005）。这些患者的症状持续时间较长（P = 0.04），体温较高（P = 0.03），更广泛的蜂窝织炎（P = 0.02），白细胞增多（P <0.0001）和中性粒细胞（P <0.0001）计数，血清肌酐（P = 0.001）和CRP（P = 0.008）高于无败血症的患者。在治疗方面，败血症患者更可能接受初始抗菌方案的改变（P <0.0001），接受更多的抗菌药物（P <0.0001），接受更长的静脉内治疗（P = 0.03）以及更常见的手术（P = 0.01）比无败血症的患者高。白细胞计数（P = 0.002），血清肌酐（P = 0.003），血液培养图（P = 0.004），初始抗菌方案的改变（P = 0。在多变量分析中，007）和蜂窝织炎的长度（P = 0.009）与脓毒症的发生独立相关。这些患者的败血症与血液白细胞和血清肌酐增加，抽血培养，初始抗菌方案的改变以及最大蜂窝织炎有关。