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Real-World Evidence of Disease Burden in Obese Patients Hospitalized With Acute Bacterial Skin and Skin-Structure Infections

McGinnis, Emily, MS*; Ayyagari, Rajeev, PhD; Tan, Ruo-Ding, PhD; Tuttle, Edward, PhD; Cammarata, Sue, MD*; Tillotson, Glenn, PhD§

Infectious Diseases in Clinical Practice: November 2018 - Volume 26 - Issue 6 - p 333–338
doi: 10.1097/IPC.0000000000000688
Original Articles

Purpose Common causes of hospitalizations in the United States are acute bacterial skin and skin-structure infections (ABSSSIs). The objectives of this retrospective study were to characterize hospitalized ABSSSI patients including comorbidities and identify the microorganisms associated with the infection.

Methods Adults (>18 years) hospitalized with 1 or more primary ABSSSI diagnosis were selected from the Cerner Health Facts electronic medical records database between 2009 and 2013. Causative microorganisms for ABSSSI and Gram-stain type were identified from microbiology culture, including patients with methicillin-resistant Staphylococcus aureus (MRSA).

Results Of the 11,705 patients identified, 51.8% were male, with a mean age of 55 years at admission; 49.7% were obese; and 30.9% had diabetes. More than half (56.6%) of patients had no microbiology culture results. Of the patients with an identified ABSSSI-causing pathogen, 63.9% were gram-positive, including 18.4% infected with MRSA; 11.9% were gram-negative; and 24.2% had mixed infections (gram-positive and gram-negative), including 3.6% with MRSA. After adjusting for confounding variables, a significant association was noted between obesity and 30-day ABSSSI-related readmission among males, patients younger than 65 years, and patients without MRSA.

Implications Hospitalized ABSSI patients had comorbidities, including obesity, diabetes, hypertension, and depression, which can complicate antibiotic selection. Patient characteristics and pathogen coverage must be considered in antibiotic selection in ABSSSI.

From the *Melinta Therapeutics, Inc., New Haven, CT;

Analysis Group, Inc, Boston, MA;

Analysis Group, Inc., Menlo Park, CA; and

§GST Micro LLC, Henrico VA.

Correspondence to: Sue Cammarata, MD, Melinta Therapeutics, 300 Tri-State International, Suite 272, Lincolnshire, IL 60069. E-mail:

The results in this article were presented at the ISPOR 20th Annual International Meeting (Philadelphia, PA; May 16 to 20, 2015) and IDWeek (New Orleans, LA; October 26 to 30, 2016).

E.M., R.A., R.-D.T., and E.T. were all involved in the study design. S.C. and G.T. were involved in data assessment. All authors were involved in writing the manuscript. E.M. and S.C. were employees at the time of the study. All authors have approved the final version of this manuscript. Editorial assistance was provided under the direction of the author(s) with support from Julie B. Stimmel, PhD.

This study was funded by Melinta Therapeutics, Inc.

E.M. holds Melinta stock. S.C. is an employee of Melinta and holds Melinta options. R.A, R.-D.T., and E.T. are all employees of Analysis Group. G.T. is a consultant to Melinta, Summit plc, and KBP Biosciences.

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