• Faiza Zeeshan, Asma Naeem, Fakhar Uddin, Bahram Khan Khoso, and Binish Arif Sultan.
• Department of Pathology, Jinnah Sindh Medical University, Karachi, Pakistan.
• J Coll Physicians Surg Pak. 2025 Jan 1; 35 (1): 495449-54.

ObjectiveTo determine the clinical microbial synergy in skin and soft tissue infections (SSTIs) based on bacterial groups and explore the likelihood ratios of clinical parameters.Study DesignDescriptive cross-sectional study. Place and Duration of the Study: The study was conducted at the Department of Microbiology, University of Karachi in collaboration with Jinnah Postgraduate Medical Centre, and Jinnah Sindh Medical University, Karachi, Pakistan, from June 2023 to May 2024.MethodologyA total of 304 pus samples from clinically diagnosed cases of SSTIs were included in the study and were processed for microbiological work-up. Isolates were cultured on blood and MacCokney's agar media. Staphylococcal species were identified via the Rapid-ID staph plus system. Continuous data was represented as mean and standard deviation and categorical data were expressed as frequencies (percentages) and were further analysed by using the Chi-square test and multinomial regression model.ResultsThe study revealed substantial associations between bacterial types and factors such as clinical unit, ethnicity, skin-barrier disruptions, infection site, and wound classification (p-value <0.05) in SSTIs. Metabolic and endocrine disorders increased the odds ratio of gram-negative rod infections (OR = 3.25). Accidents and trauma were associated with higher odds ratio of gram-positive cocci infections (OR = 3.288). Bacterial types varied across wound classes, with gram-positive cocci more common in classes I, II, and III (OR = 3.29, 2.00).ConclusionThis study identifies key predictors of bacterial aetiology in skin SSTIs, revealing increased associations between gram-negative rods and metabolic and endocrine disorders, gram-positive cocci and trauma-related SSTIs, and gram-negative rods in surgical site infections.Key WordsBacterial infections, Infection control, Soft tissue infections, Surgical site infections.

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