Bacterial skin and soft tissue infections: review of the epidemiology, microbiology, aetiopathogenesis and treatment

Abstract

Bacterial skin and soft tissues infections (SSTI) often determine acute disease and frequent emergency recovering, and they are one of the most common causes of infection among groups of different ages. Given the variable presentation of SSTI, a thorough assessment of their incidence and prevalence is difficult. The presence of patient-related (local or systemic) or environmental risk factors, along with the emergence of multi-drug resistant pathogens, can promote SSTI. These infections may present with a wide spectrum of clinical features and different severity, and can be classified according to various criteria. Many bacterial species can cause SSTI, but Gram-positive bacteria are the most frequently isolated, with a predominance of Staphylococcus aureus and Streptococcus pyogenes. The diagnosis of SSTI requires an extended clinical history, a thorough physical examination and a high index of suspicion. Early diagnosis is particularly important in complicated infections, which often require laboratory studies, diagnostic imaging and surgical exploration. SSTI management should conform to the epidemiology, the aetiology, the severity and the depth of the infection. Topical, oral or systemic antimicrobial therapy and drainage or debridement could be necessary, along with treatment of a significant underlying disease. This review discusses the epidemiology, the pathogenesis and the classification of bacterial SSTI, describes their associated risk factors and their clinical presentations. The authors provide a rational diagnostic and therapeutic approach to SSTI in respect of antibiotic resistance and currently available antimicrobial agents.

Antibacterial photosensitization through activation of coproporphyrinogen oxidase

“…Furthermore, ∼10% of hospitalized patients suffer from an SSTI (1). These infections are typically caused by Gram-positive bacteria including Staphylococcus aureus, Staphylococcus epidermidis, Propionibacterium acnes, and Bacillus anthracis, the causative agents of "staph infections," hospital-acquired infections, acne, and cutaneous anthrax, respectively (1)(2)(3)(4).…”

“…S. aureus and P. acnes are the most prevalent causative agents of SSTIs (1)(2)(3)(4). In fact over 90% of the world's population will suffer from acne over the course of their lifetime, leading to annual direct costs of over $3 billion (1,2,5,6). The threat of these pathogens is compounded by the tremendous rise in antibiotic resistance, reducing the efficacy of the existing antibacterial armamentarium (1,3,4).…”

“…bacteria | photosensitization | CgoX | heme | antibiotic S kin and soft tissue infections (SSTIs) are responsible for a majority of visits to hospitals and clinics in the United States, accounting for ∼14 million ambulatory care visits each year (1). Furthermore, ∼10% of hospitalized patients suffer from an SSTI (1).…”

“…These infections are typically caused by Gram-positive bacteria including Staphylococcus aureus, Staphylococcus epidermidis, Propionibacterium acnes, and Bacillus anthracis, the causative agents of "staph infections," hospital-acquired infections, acne, and cutaneous anthrax, respectively (1)(2)(3)(4). S. aureus and P. acnes are the most prevalent causative agents of SSTIs (1)(2)(3)(4). In fact over 90% of the world's population will suffer from acne over the course of their lifetime, leading to annual direct costs of over $3 billion (1,2,5,6).…”

“…In fact over 90% of the world's population will suffer from acne over the course of their lifetime, leading to annual direct costs of over $3 billion (1,2,5,6). The threat of these pathogens is compounded by the tremendous rise in antibiotic resistance, reducing the efficacy of the existing antibacterial armamentarium (1,3,4). Identifying new drug targets to treat SSTIs is paramount to enable the development of novel therapeutics.…”