Cellulitis incidence in a defined population

Simonsen, Sara; Orman, E. R. Van; Hatch, Brigit; Jones, Spencer S.; Gren, Lisa H.; Hegmann, Kurt T.; Lyon, Joseph L.

doi:10.1017/s095026880500484x

Cited by 260 publications

(201 citation statements)

References 9 publications

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“…17 The prevalence of foot ulcers in the late 50's might be due to the occurrence of neuropathy, vasculopathy and altered immune responses in diabetic individuals and they are more evident in the later age groups as the disease progress. 18 The present study showed male preponderance with 81 males & 22 females. Male preponderance in the present study could be explained on the basis that the males spend more time working outdoors, exposing their foot to more traumas.…”

Section: Discussionsupporting

confidence: 55%

Bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques

Patil

Mane

2017

Int J Res Med Sci

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INTRODUCTIONDiabetes mellitus (DM) is one of the major public health problems whose prevalence is rapidly rising all over the globe at an alarming rate. Nowhere is the diabetic epidemic more pronounced than in India, as the WHO reports show that 69.2 million people had diabetes in the year 2015.1 Patients with DM are prone to multifarious complications such as diabetic foot ulcer (DFU). DFU is a common complication of DM that has shown an growing trend over previous periods. [2][3][4] At some time in their life, 15% of people with diabetes mellitus develop foot ulcers that are highly susceptible to infection.5 On estimation, the prevalence of this complication ranges ABSTRACT Background: Diabetic foot ulcers (DFU) are the complications of diabetes mellitus. The diabetic foot ulcer infections are polymicrobial in nature. If they are not recognized and controlled it leads to many devastating consequences like limb amputation, sepsis, and even mortality. Hence, the present study was undertaken to determine the bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques and the antimicrobial sensitivity pattern of the isolates. Methods: A total number of 103 patients with a foot ulcer of Wagner's grade II or more and evidence of purulent exudates or edema were included in the study. Swab samples were obtained from the base of ulcers and were sent for bacteriological study. The specimen was processed in the microbiology laboratory for Gram stain, aerobic culture, and anaerobic culture. The organisms isolated were identified by standard procedures and antimicrobial susceptibility was done by Kirby-Bauer disc diffusion method. Results: A total no of 253 organisms were isolated from 103 patients. Out of these, 217 aerobes were isolated, and the most common organism isolated from gram positive bacteria was Staphylococcus aureus, 53 (24.42 %). Pseudomonas aeruginosa, 42 (19.35 %) was the predominant organism isolated from gram negative bacteria. Among the total 36 anaerobes, Bacteroides fragilis group, 17 (47.22 %) was the most common organism isolated. All the gram positive aerobic organisms were found to be sensitive for vancomycin. Among the gram negative organisms, E. coli, Proteus mirabilis, Proteus vulgaris, showed more sensitivity to cefotaxime (90.62%, 91.66%, 75%) respectively. Metronidazole was the drug of choice in case of anaerobes followed by imipenem. Conclusions: It is necessary to identify the etiological factors and susceptible microorganisms responsible for causation of DFU. So that prompt management of diabetic foot ulcers is possible for successful outcome. Appreciation of the causative organisms in diabetic foot and their antibiotic sensitivity is essential for institution of appropriate antibiotic therapy.

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Section: Discussionsupporting

confidence: 55%

Bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques

Patil

Mane

2017

Int J Res Med Sci

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“…The study population was similar to that described in literature with a predominance of older people and men. 3,11,12 The clinical presentations were also classical with diabetes mellitus as a major risk factor. 4,[13][14][15][16] Most of the patients received Inj crystalline penicillin and cloxacillin for Streptococci and Staphylococci.…”

Section: Discussionmentioning

confidence: 99%

Subcutaneous pressure in cellulitis of the leg: can it be a predictor for early surgical intervention?

Nadarajan¹,

Chase²,

Roopavathana³

et al. 2016

Int Surg J

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INTRODUCTIONCellulitis is a spreading bacterial infection of the dermis and subcutaneous tissues. It occurs among both men and women. 1 The incidence of lower limb cellulitis was reported relatively high with 199 cases per 100,000 person-years in a population based study. 2 The most common causative organisms are Streptococcus pyogenes and Staphylococcus aureus. 3 The risk factors are toe web intertrigo, leg ulcers, trauma causing breach in the skin continuity, venous insufficiency, lymphedema, diabetes, obesity and immuno-compromised conditions. The most common risk factors for recurrence are venous insufficiency and lymphedema and previous episode of cellulitis. 4 The most common pathogenesis is the breach in skin integrity especially the toe web space. The Streptococci and Staphylococci produce toxins which cause inflammatory mediator release, resulting in the edema and skin changes.5 If the infection is persisting in the subcutaneous plane, the edema worsens leading to local complications resulting in systemic sepsis and multiple organ dysfunction. The common clinical ABSTRACT Background: Cellulitis, an infection of skin and subcutaneous tissue is usually managed conservatively and surgical intervention is required for local complications. The aim of this study was to correlate the subcutaneous pressure with the need for early surgical intervention in cases of lower limb cellulitis. Methods: We prospectively measured subcutaneous pressures in the normal leg and in the leg with cellulitis. Patients managed with parenteral antibiotics were compared to those managed with parenteral antibiotics and surgical intervention with standard statistical tests. Results: The median subcutaneous pressure was 3 mmHg and 9 mmHg in the normal leg and the other with cellulitis respectively. The mean of difference in subcutaneous pressure in legs with cellulitis compared to normal legs was 5.93 mmHg and 8.29 mmHg in the conservative group and surgical intervention group respectively. The difference in subcutaneous pressure between the normal leg and in the leg with cellulitis was statistically significant (p<0.001). The difference in the average pressure between surgical intervention group and conservative group was 2.36 mmHg and was statistically significant (p<0.05). The optimal threshold (difference in pressure) was identified as >=7 with sensitivity of 85.7% and specificity of 57.1%. Area under the ROC curve (SE) was 0.71 (0.10) with 95% CI (0.51, 0.87). Conclusions:The subcutaneous pressure in leg with cellulitis is a predictor for the need for early surgical intervention. It can be used as an adjunct in management and clinical decision making for cases of cellulitis of lower limbs.

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“…Our findings of HIVassociated NF incidence being 14 hospitalizations per 100,000 personyears support the proposed increased risk of NF in HIV-infected patients, markedly above that reported in the general population. A commonly cited multistate incidence estimate of NF in the United States (US) is 4 per 100,000, based on a report by Ellis Simonsen and colleagues [19] using administrative data from 1997-2002. A markedly lower incidence of NF was found by Mulla et al in another population study, using similar approach, with NF reported in 1.3 per 100,000 hospital discharges in Florida in 2001 [20].…”

Section: Discussionmentioning

confidence: 99%

Human Immunodeficiency Virus Infection Associated with Necrotizing Fasciitis: A Cohort Study of Texas Population, 2001-2010

Oud¹

2014

J Infect Dis Ther

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Cellulitis incidence in a defined population

Cited by 260 publications

References 9 publications

Bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques

Bacterial and clinical profile of diabetic foot ulcer using optimal culture techniques

Subcutaneous pressure in cellulitis of the leg: can it be a predictor for early surgical intervention?

Human Immunodeficiency Virus Infection Associated with Necrotizing Fasciitis: A Cohort Study of Texas Population, 2001-2010

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