<i>Staphylococcus aureus</i>versus<i>Streptococcus pyogenes</i>in hand infection

Lebowitz, Dan; Müller, Camillo A; Balagué, Nicolas; Vostrel, Philippe; Beaulieu, Jean-Yves; Uçkay, İlker

doi:10.3109/23744235.2015.1049463

Cited by 7 publications

(3 citation statements)

References 4 publications

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“…Staphylococcus aureus was the most commonly isolated pathogen, found in 48 episodes (31%); none of the strains was a methicillin-resistant strain. Streptococci were involved in 22 cases,20 Gram-negative pathogens in 35 episodes (including 19 due to Pasteurella spp,18 and skin commensals (coagulase-negative staphylococci, micrococci, corynebacteria or cutibacteria) in seven cases and the rest consisted of other pathogens. Twenty-one infections were bimicrobial, and there were no polymicrobial cases.…”

Section: Resultsmentioning

confidence: 99%

Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial

et al. 2019

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ObjectiveThe optimal duration of postsurgical antibiotic therapy for adult native joint bacterial arthritis remains unknown.MethodsWe conducted a prospective, unblinded, randomised, non-inferiority study comparing either 2 or 4 weeks of antibiotic therapy after surgical drainage of native joint bacterial arthritis in adults. Excluded were implant-related infections, episodes without surgical lavage and episodes with a follow-up of less than 2 months.ResultsWe enrolled 154 cases: 77 in the 4-week arm and 77 in the 2-week arm. Median length of intravenous antibiotic treatment was 1 and 2 days, respectively. The median number of surgical lavages was 1 in both arms. Recurrence of infection was noted in three patients (2%): 1 in the 2-week arm (99% cure rate) and 2 in the 4-week arm (97% cure rate). There was no difference in the number of adverse events or sequelae between the study arms. Of the overall 154 arthritis cases, 99 concerned the hand and wrist, for which an additional subgroup analysis was performed. In this per-protocol subanalysis, we noted three recurrences: one in the 2-week arm (97 % cure); two in the 4-week arm (96 % cure) and witnessed sequelae in 50% in the 2-week arm versus 55% in the 4-week arm, of which five (13%) and six (13%) needed further interventions.ConclusionsAfter initial surgical lavage for septic arthritis, 2 weeks of targeted antibiotic therapy is not inferior to 4 weeks regarding cure rate, adverse events or sequelae and leads to a significantly shorter hospital stay, at least for hand and wrist arthritis.Trial registration numberNCT03615781.

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Section: Resultsmentioning

confidence: 99%

Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial

et al. 2019

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“…It is important to remember that most hand infections do not require a trip to the operating room and may be effectively managed through a bedside drainage. Chung et al10 examined 146 patients over a 10-year period and found that only 12% of PHIs required incision and drainage (I&D) in the operating room, with 51% of patients effectively treated with bedside I&D. Certain pathogens may be more likely to benefit from intervention, as Lebowitz et al23 found that 100% of patients who presented with a hand infection secondary to S. aureus or Group A Streptococcus required surgical debridement as part of their treatment. In addition, atypical hand infections, such as those because of Mycobacteria , often do not respond to typical antibiotic therapy and thus may require surgical intervention 24…”

Section: Discussionmentioning

confidence: 99%

Operative Pediatric Hand Infections: A Retrospective Review

Grome¹,

Raj²,

Abu‐Ghname³

et al. 2021

Journal of Pediatric Orthopaedics

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Background: Infections in the pediatric population are a less well studied topic in hand surgery. Crucial aspects of the management of pediatric hand infections differ from adults, though much of current treatment is generalized from adult care. This study evaluates our clinical experience with regards to the epidemiology, management, and outcomes of pediatric hand infections requiring operative intervention. Methods: A 7-year retrospective chart review was performed of all pediatric patients who required operative intervention for hand infections at Texas Children's Hospital. Clinical information was collected and analyzed, including demographics, infection characteristics, management, and outcomes. Results: Fifty-seven patients met the inclusion criteria for our study over the 7-year period. Of these, 7% (n = 4) had a preexisting diagnosis of diabetes mellitus, and 5% (n = 3) had a recent history of upper extremity infections. The most common infection was a discrete abscess, whereas urgent/emergent conditions represented 25% (n = 14) of infections. Radiographic changes consistent with osteomyelitis were present in over onequarter of patients (n = 13, 23%). The median length of hospital stay was 3 days (95% confidence interval: 3.05-5.05) and the most common pathogen was Staphylococcus aureus (n = 33, 58%), with slightly more being methicillin sensitive (MSSA) than resistant (MRSA) (n = 19, 33% vs. n = 14, 25%). The incidence of reoperation was 12.5% (n = 7). Conclusions: Hand infections are a common problem in the pediatric population. Cases tend to be associated with accidental trauma and discrete abscesses colonized by MSSA/MRSA. The vast majority of cases require only one operation and a short course of wound care before discharge.

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“…In one study, only a minority of patients with prior culture-proven S. aureus skin infection remained colonized with the same organism after treatment in the convalescent phase, and only a quarter of their household contacts were colonized with the index infecting strain (Brown et al, 2014;Miller et al, 2012). Small studies of patients with infections caused by methicillin-susceptible S. aureus, MRSA (Zenelaj et al, 2014) or streptococci (Lebowitz et al, 2015) failed to show a difference in remission incidences on the long term. The duration of clinical follow-up in most publications regarding soft tissue or musculoskeletal infections has been no more than 2 years, except in some studies of arthroplasty infections.…”

Section: Discussionmentioning

confidence: 99%

Staphylococcus aureus soft tissue infection may increase the risk of subsequent staphylococcal soft tissue infections

Bouvet

Gjoni

Zenelaj

et al. 2017

International Journal of Infectious Diseases

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Background: Staphylococcus aureus is the most common cause of soft tissue infections. It is unknown, however, if a patient who has had such an infection is at greater risk for future soft tissue infections with S. aureus. Methods: We conducted an epidemiological survey of adult patients hospitalized in the only public hospital in Geneva for treatment (usually combined surgical and medical) of a soft tissue infection caused by S. aureus. By reviewing nursing and medical records from the emergency department and hospital wards, we assessed whether or not they developed any other soft tissue infections (excluding a recurrence) after or before the index one. Results: Among 1023 index episodes of soft tissue infections, 670 (65%) were caused by S. aureus, of which 47 were caused by methicillin-resistant strains (30 healthcare-associated and 17 community-acquired). The patients' median age was 51 years and 334 (34%) were immune-compromised. The median time span between the patient's first and last consultation (for any reason) in our hospital was 21.4 years (interquartile range, 10-30 years). In addition to their index infection, 124 patients (12%) developed a new nosocomial or community-acquired soft tissue infection. Among the index cases with an S. aureus infection, 92 (14%) had another soft tissue infection, compared to 32 (9%) who had a non-staphylococcal index infection (Pearson-x 2-test; p = 0.03). Similarly, patients with an index S. aureus infection, compared to those with a non-S. aureus infection, had a higher rate of another soft tissue infection caused by S. aureus (x 2-test; p < 0.01). In multivariate analysis, an index infection due to S. aureus shows a high association to further S. aureus soft tissue infections (logistic regression; odds ratio 2.5, 95% confidence interval 1.4-4.6). Conclusion: Among adult patients hospitalised for a soft tissue infection, those infected with S. aureus (compared with other pathogens) may be at higher risk of a subsequent soft tissue infection, particularly with S. aureus.

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Staphylococcus aureusversusStreptococcus pyogenesin hand infection

Cited by 7 publications

References 4 publications

Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial

Two weeks versus four weeks of antibiotic therapy after surgical drainage for native joint bacterial arthritis: a prospective, randomised, non-inferiority trial

Operative Pediatric Hand Infections: A Retrospective Review

Staphylococcus aureus soft tissue infection may increase the risk of subsequent staphylococcal soft tissue infections

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