Clinical Guidelines for the Antibiotic Treatment for Community-Acquired Skin and Soft Tissue Infection

Kwak, Yee Gyung; Choi, Seong Ho; Kim, Tark; Park, Seong Yeon; Seo, Soo Hong; Kim, Min Bom; Choi, Sang Ho

doi:10.3947/ic.2017.49.4.301

Cited by 70 publications

(78 citation statements)

References 92 publications

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“…Macía-Rodríguez et al reported that an inadequate empirical therapy of SSTI resulted in greater mortality (OR 44.74, 95% CI 5.40-370.73) (Macía-Rodríguez et al, 2017). Although the present study data did not show an increase in hospital stay, complications, or mortality for patients with MRSA SSTI, which may be explained by younger age and fewer comorbidities in the MRSA SSTI group and limited power in our sample, it confirms the need for MRSA coverage in purulent SSTI to attempt to improve microbiological cure (Stevens et al, 2014;Kwak et al, 2017). More studies are needed to assess the impact of inappropriate initial therapy on outcomes.…”

Section: Discussioncontrasting

confidence: 58%

Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia

Valderrama-Beltrán

Gualtero

Álvarez-Moreno

et al. 2019

International Journal of Infectious Diseases

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Objectives: Methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTIs) represent a major clinical problem in Colombia. The aim of this study was to evaluate the risk factors associated with MRSA SSTI in Colombia. Methods: A multicenter cohort study with nested case-control design was performed. Patients with an SSTI with at least 48 h of inpatient care were included. Patients with an MRSA SSTI were considered the case group and patients with either a non-MRSA SSTI or with an Methicillin-susceptible S. aureus (MSSA) SSTI were the control groups. A multivariate logistic regression approach was used to evaluate risk factors associated with MRSA SSTI with two different statistical models. Results: A total 1134 patients were included. Cultures were positive for 498 patients, of which 52% (n = 259) were Staphylococcus aureus. MRSA was confirmed in 68.3% of the S. aureus cultures. In the first model, independent risk factors for MRSA SSTI were identified as the presence of abscess (P < 0.0001), cellulitis (P = 0.0007), age 18-44 years (P = 0.001), and previous outpatient treatment in the previous index visit (P = 0.003); surgical site infection was a protective factor (P = 0.008). In the second model, the main risk factor found was previous outpatient treatment in the previous index visit (P = 0.013). Conclusions: Community-acquired SSTIs in Colombia are commonly caused by MRSA. Therefore, clinicians should consider MRSA when designing the initial empirical treatment for purulent SSTI in Colombia, although there seems to be low awareness of this fact.

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Section: Discussioncontrasting

confidence: 58%

Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia

Valderrama-Beltrán

Gualtero

Álvarez-Moreno

et al. 2019

International Journal of Infectious Diseases

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“…Furthermore, blood, aspirate and other biopsy material cultures are no longer routinely recommended for simple, nonpurulent CA-SSTIs because of low isolation of causative microorganism rates (12). In another domestic guideline recently reported by the Korean authors, routine blood, aspiration, or punch biopsy culture was recommended only in immunosuppressive patients, similar to that reported in the IDSA guideline (14) In our study, causative microorganisms were isolated from 47% of included patients; in other words, our bacteria isolation rate was higher than that reported previously (12). We attribute this high rate to the facts that patients with CSSTI comprised 57% of our study population and that most cultures were grown from deep swab and tissue samples.…”

Section: Discussionmentioning

confidence: 85%

Evaluation of Risk Factors for Osteoporosis and Osteopenia in Male Patients Aged Over 60 Years of Age

C��BDEN¹

2018

tjgeri

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Introduction: This study investigated differences in clinical features, types, etiology, and risk factors for complications between young and older patients with skin and soft tissue infections. Futhermore, age-related differences in healthcare-associated and complicated infections were identified.Materials and Method: This retrospective study included 206 skin and soft tissue infection patients hospitalized during an 8-year period. Data were collected using a form: patients' characteristics, clinical features, laboratory values, prior antibiotic use, causative microorganisms, and antibiotic treatment. For cases with clinically diagnosed, samples were taken from the suspected infection sites. Gram staining, deep swab, deep tissue and blood culture results were evaluated.Results: The incidence of diabetes mellitus was significantly higher among patients aged ≥65 years. Among these old patients, Escherichia coli (11/31, 35.5%) and Pseudomonas aeruginosa (8/31, 25.8%) were the most frequently isolated pathogens. Approximately half of the Staphylococcus aureus and Staphylococcus epidermidis strains isolated from patients with health care-associated infection were resistant to methicillin (8/15, 53.3%), and these patients produced higher levels of extended-spectrum beta-lactamase. Venous insufficiency (p=0.008) and prior hospitalization (p=0.001) were identified as risk factors for complication in patients aged ≥65. The median time-to -clinical response was 7 days in older patients with non-complicated infection (p=0.007).Conclusion: Diabetes mellitus was the most common co-morbid factor in older patients. Risk factors for complication may differ by age. Gram-negative pathogens were more commonly isolated in older patients. The time-to -clinical response was significantly longer in older patients with non-complicated infection than young patients.Keywords: Cellulitis; Diabetic foot; Aged; Cross Infection; Risk factors Giriş: Bu çalışmada, deri ve yumuşak doku enfeksiyonu tanısı alan genç ve yaşlı hastalar arasında klinik özellikler, tip, etiyoloji ve komplike edici risk faktörleri açısından farklılıklar araştırıldı. Ayrıca sağlık bakımı ilişkili ve komplike deri ve yumuşak doku enfeksiyonlu hastalarda yaşla ilişkili farklılıklar belirlendi.Gereç ve Yöntem: Bu retrospektif çalışmaya sekiz yıllık süre içinde deri ve yumuşak doku enfeksiyonu tanısı alıp yatırılan 206 hasta alındı. Hastaların karakteristik ve klinik özelliklerini, laboratuvar değerlerini, öncesinde antibiyotik kullanımlarını, izole edilen etken mikroorganizmaları ve antibiyotik tedavilerini içeren veriler bir forma kaydedildi. Klinik olarak deri ve yumuşak doku enfeksiyonu tanısı koyulanların şüpheli enfeksiyon bölgelerinden örnekler alındı. Gram boyama, derin sürüntü, doku ve kan kültürleri değerlendirildi.Bulgular: Diabetes mellitus, 65 yaş ve üzerindeki hastalarda yüksekti. Bu yaşlı hastalar arasında Escherichia coli (11/31, %35,5) ve Pseudomonas aeruginosa (8/31, %25,8), en sık izole edilen patojenlerdi. Sağlık bakımı ilişkili hastalardan izole edile...

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“…Necrotizing infections most commonly involve the muscular fascial layers but may also involve the dermal, subcutaneous, and muscle layers and warrant prompt, aggressive surgical debridement [4]. Because of the rapid progression of these diseases, most guidelines [3,5,15] recommend broad-spectrum antibiotics to cover GPB and GNB. Our study con rmed the signi cance of antibiotic treatment against GNB.…”

Section: Discussionmentioning

confidence: 99%

Microbial Distribution and Antibiotic Susceptibility in Patients with Complicated Skin and Soft Tissue Infections of the Extremities in North-Eastern China

Song

Wang

et al. 2020

Preprint

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Background For complicated skin and soft tissue infections (cSSTIs), inappropriate initial anti-infective treatment often leads to treatment failure. The microbial distribution in patients with extremities’ cSSTIs has been rarely reported. Moreover, whether gram-negative bacteria (GNB) should be covered in addition to gram-positive bacteria (GPB) has been always a difficult issue in the treatment of cSSTIs. Methods We retrospectively analyzed the microbial distribution and antibiotic susceptibility in 149 hospitalized patients with extremities’ SSTIs, and discussed the risk factors of extremities’ cSSTIs caused by GNB. Results 188 strains of pathogens were isolated, including 113 strains of GPB (64.9%), 61 strains of GNB (32.4%), and 5 strains of fungi (2.7%). Diabetes mellitus (OR=3.606, P =0.034), SSTI severity [moderate infection (OR=19.499, P <0.0001), severe infection (OR=20.114, P <0.0001)], and necrotizing infection (OR=6.064, P <0.0001) were risk factors of extremities’ cSSTIs caused by GNB. For patients with risk factors, ceftazidime, cefepime, piperacillin/tazobactam and carbapenems could be empirical anti-infective agents. Conclusions The results of our study showed that the most common bacteria identified in cSSTIs of the extremities were GPB. For patients with risk factors of extremities’ cSSTIs caused by GNB, the coverage of GNB should be taken into account.

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Clinical Guidelines for the Antibiotic Treatment for Community-Acquired Skin and Soft Tissue Infection

Cited by 70 publications

References 92 publications

Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia

Risk factors associated with methicillin-resistant Staphylococcus aureus skin and soft tissue infections in hospitalized patients in Colombia

Evaluation of Risk Factors for Osteoporosis and Osteopenia in Male Patients Aged Over 60 Years of Age

Microbial Distribution and Antibiotic Susceptibility in Patients with Complicated Skin and Soft Tissue Infections of the Extremities in North-Eastern China

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