Skin and soft tissue infections in people migrating by sea to the Canary Islands, Spain.

Introduction: People migrating to the Canary Islands by sea frequently suffer from potentially severe skin and soft tissue infections (SSTIs) for which optimal empirical antibiotic therapy is not well defined.

Methods: This descriptive retrospective observational study assess a case series of newly arrived maritime migrants to the Canary Islands who were diagnosed with clinical and microbiological SSTIs and admitted to the Nuestra Señora de La Candelaria Hospital in Tenerife between January 2020 and December 2023. Clinical data, bacterial species, resistance profiles, and choice of empirical treatments were analysed.

Results: A total of 23 patients with SSTIs were analysed, with 21 (91.3%) presenting lesions in the gluteal-sacral region. Thirty-seven community-acquired pathogenic microorganisms were isolated, including seven from blood cultures. The isolated bacteria included Staphylococcus aureus (n=12/37; 32.4%), Enterobacterales (n=9/37; 24.3%), marine bacteria (n=7/37; 18.9%), non-fermenting gram-negative bacteria (n=6/37; 16.2%), and other gram-positive cocci (n=2/37; 5.4%). Treatment was inappropriate in 9 of 23 cases (39.1%), with amoxicillin/clavulanic acid being the most prescribed antibiotic (n=11/23; 47.8%).

Conclusions: The study suggests that, in addition to the importance of bacteria such as S. aureus, consideration should be given to Enterobacterales, marine bacteria, and gram-negative non-fermenting bacteria (such as Pseudomonas aeruginosa) when choosing empirical antibiotic therapy for SSTIs in maritime migrants.