Trauma
Burns
Bacteremia in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Epidemiology, Risk Factors, and Predictive Value of Skin Cultures
de Prost N, Ingen-Housz-Oro S, Duong TA, et al (Université Paris XII, Créteil, France) Medicine 89:28-36, 2010§
Evidence Ranking
• C
Expert Rating
• 1
Abstract
Toxic epidermal necrolysis (TEN) is a rare drug-related life-threatening acute condition. Sepsis is the main cause of mortality. Skin colonization on top of impaired barrier function promotes bloodstream infections (BSI). We conducted this study to describe the epidemiology, identify early predictors of BSI, and assess the predictive value for bacteremia of routine skin surface cultures.
We retrospectively analyzed the charts of all patients with Stevens-Johnson syndrome (SJS) and TEN hospitalized over an 11-year period. Blood cultures and skin isolates were recovered from the microbiology laboratory database. Early predictors of BSI were identified using a Cox model. Sensitivity, specificity, and negative and positive predictive values of skin cultures for the etiology of BSI were assessed.