Discuss and Consider Adding Surveillance of Skin and Soft-Tissue Infections

[Brar]

One of our LMIC partners observed cases of skin and soft tissue infections, thrombophlebitis, omphalitis, and abscesses, and postulated that this would be a common occurrence in this setting.

We had a preliminary discussion on this topic and concluded that clinical sepsis should not be expanded to include these types of infections. This is to prevent the increase in misclassification of different entities that are typically non-bacteremic and may have less impact on morbidity and mortality, as clinical sepsis, thereby reducing the impact of epidemiological data on (suspected) sepsis.

Data from the initial stages of the NEO-KISS surveillance system indicate that skin infections occur with the same or even greater frequency than pneumonia overall, including in VLBW infants [1]. This indicates that monitoring for skin infections may be a valuable addition to the surveillance strategy, despite the potential lower relevance regarding long-term morbidity or mortality.

1. Hentschel, J., et al., Neonatal nosocomial infection surveillance: incidences by site and a cluster of necrotizing enterocolitis. Infection, 1999. 27(4-5): p. 234-8.