Clinical and Inflammatory Predictors of Treatment Failure in Uncomplicated Skin and Soft Tissue Infections: A Multi-Centre Study from Türkiye

Presenter: Melike Nur Özçelik

This prospective, multicenter observational study evaluated predictors of hospitalization following outpatient treatment failure in adults with uncomplicated skin and soft tissue infections (uSSTIs) across 24 centres in Türkiye (April–September 2024). Among 599 patients, 263 completed outpatient therapy, 169 were hospitalized at presentation, and 167 required hospitalization after initial outpatient treatment. Univariate analysis identified higher BMI (P=.015), chronic kidney disease (P=.044), immunodeficiency (P=.026), insect bite etiology (P=.047), and smoking (P=.019) as factors associated with hospitalization. Clinical predictors included preseptal cellulitis (P<.001), lesion size >10% body surface area (BSA, P<.001), and elevated pulse rate (P<.001). Laboratory predictors included elevated neutrophil-to-lymphocyte ratio (NLR >4.37, P<.001), C-reactive protein (CRP >67.5 mg/L, P<.001), and other inflammatory markers.

Multivariable analysis confirmed independent predictors: smoking (OR 3.403, 95% CI: 1.535–7.542), preseptal cellulitis (OR 42.354, 95% CI: 4.178–429.336), lesion size >10% BSA (OR 3.898, 95% CI: 1.598–9.509), CRP (OR 1.005, 95% CI: 1.001–1.008), NLR (OR 1.073, 95% CI: 1.012–1.138), and pulse rate (OR 1.027, 95% CI: 1.004–1.051).

Overall, these factors were associated with increased risk of hospitalization following outpatient treatment failure.Bottom of Form

Skin and Soft Tissue Infections in UK Armed Forces Populations: The Past, The Present and The Future

Presenter: Aaron Mason

This set of studies evaluated the epidemiology and prevention of skin and soft tissue infections (SSTIs) in UK Armed Forces populations, focusing on Staphylococcus aureus (SA) and Group A Streptococcus (GAS). Carriage studies included Royal Marine (RM) recruits (n=1012), high-risk Commonwealth recruits (Nepalese Gurkhas and Fijians, n=465), and deployed personnel (n=100). SSTI acquisition was common among RM recruits (35%), with SA nasal carriage at 23% and MRSA and PVL <1%. S. argenteus carriage with asymptomatic transmission was also observed. Among Nepalese Gurkhas, SA nasal carriage was 7.4%, with 12.5% MRSA and 40% PVL-SA. In Fijians, SA carriage was 32% (no MRSA, 6.6% PVL), with 18.4% Staphylococcus lugdunensis carriage. No MRSA or PVL acquisition was observed in deployed British personnel in Brunei.

Preventive strategies showed that bolus vitamin D supplementation (n=1815) did not reduce SSTI acquisition. During an outbreak, heavy environmental contamination with PVL-MSSA was identified, which decreased following enhanced cleaning and behavioural interventions.

Overall, SSTIs are common in UK Armed Forces, with varying carriage patterns across populations and limited impact of vitamin D supplementation on prevention.

ESCMID 2026, 17-21 April, Munich, Germany.