Impetigo: An Overview

Darmstadt, L M D Gary; Lane, Alfred T.

doi:10.1111/j.1525-1470.1994.tb00092.x

Cited by 127 publications

(52 citation statements)

References 88 publications

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“…Adherence of the M6-protein strain, however, was greater to undifferentiated than differentiated keratinocytes (53). This is opposite to what one would predict based on the histopathology of impetigo (23), which shows localization of the infection to highly differentiated subcorneal keratinocytes. The complexity of bacterium-host interactions was further illustrated when various M proteins were expressed in an isogenic group A streptococcal background and their adherence to transformed human keratinocytes was compared (8).…”

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confidence: 55%

“…S. pyogenes adhered to keratinocytes in an inoculum-and timedependent manner suggestive of a receptor-mediated process (25). In vitro adherence of an impetigo strain of S. pyogenes was specifically promoted by keratinocyte differentiation, as is observed in lesions of impetigo (23). Presumably, host cell receptors for adherence were most highly expressed on these differentiated keratinocytes.…”

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confidence: 88%

“…Increased global incidence of severe, invasive disease due to S. pyogenes over the past decade, with the skin serving as the portal of entry in more than half of the cases, has highlighted our need to understand the molecular pathogenesis of skin infections (66). Pathogenic mechanisms of streptococcal skin infections are almost entirely unknown, however, since efforts have focused on the interaction of streptococci with mucosal epithelium, and in vitro models which emulate human skin disease (23) have not been available.…”

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confidence: 99%

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Role of Group A Streptococcal Virulence Factors in Adherence to Keratinocytes

et al. 2000

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To evaluate the role of putative group A streptococcal virulence factors in the initiation of skin infections, we compared the adherence of a wild-type M49-protein skin-associated strain to that of a series of 16 isogenic mutants created by insertional inactivation of virulence genes. None of the mutants, including the M-proteindeficient (emm mutant) strain, displayed reduced adherence to early-passage cultured human keratinocytes, but adherence of the mutant lacking hyaluronic acid capsule expression (has mutant) was increased 13-fold. In contrast, elimination of capsule expression in M2-, M3-, and M18-protein has mutants increased adherence only slightly (1.3-to 2.3-fold) compared to their respective wild-type strains. A mutant with inactivation of both emm and has displayed high-level adherence (34.9 ؎ 4.1%) equal to that of the has mutant strain (40.7 ؉ 8.0%), confirming the lack of involvement of M49 protein in attachment. Moreover, adherence of the M49-proteindeficient (emm mutant) and wild-type strains was increased to the same level (57 and 55%, respectively) following enzymatic digestion of their hyaluronic acid capsule. Adherence of mutants lacking oligopeptide permease (Opp) expression was increased 3.8-to 5.5-fold, in association with decreased cell-associated hyaluronic acid capsule. Finally, soluble CD46 failed to inhibit adherence of M49-and M52-serotype skin strains. We conclude that (i) bacterial M protein and keratinocyte CD46 do not mediate adherence of M49 skin-associated Streptococcus pyogenes to epidermal keratinocytes, (ii) hyaluronic acid capsule impedes the interaction of bacterial adhesins with keratinocyte receptors, (iii) modulation of capsule expression may be important in the pathogenesis of skin infections, and (iv) the molecular interactions in attachment of skin strains of S. pyogenes to keratinocytes are unique and remain unidentified.Streptococcus pyogenes (group A streptococcus) is unsurpassed among bacterial pathogens in its ability to cause a variety of skin infections ranging from self-limited superficial impetigo to fulminant life-threatening, soft-tissue destruction and necrotizing fasciitis (26-28). Increased global incidence of severe, invasive disease due to S. pyogenes over the past decade, with the skin serving as the portal of entry in more than half of the cases, has highlighted our need to understand the molecular pathogenesis of skin infections (66). Pathogenic mechanisms of streptococcal skin infections are almost entirely unknown, however, since efforts have focused on the interaction of streptococci with mucosal epithelium, and in vitro models which emulate human skin disease (23) have not been available.An initial step in group A streptococcal skin infection appears to involve adherence of the bacteria via its adhesin(s) to host cell receptor(s) (25). The type of adhesin utilized for specific binding may vary depending on the streptococcal strain and type of host cell and tissue involved. M protein is the most well-documented virulence factor of S. pyogenes. ...

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confidence: 99%

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Role of Group A Streptococcal Virulence Factors in Adherence to Keratinocytes

et al. 2000

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“…Microbial skin infections are very wide spread in population of various ages and it can be classified by wound depth and pathogen species. In most cases of dermal and subdermal, primary and secondary skin bacterial infections, the disease treatment by simple topical drug application is not sufficient, a deeper penetration of antifungal drug of choice during therapy is felt very much essential 2,3 . This is due to lack of ability of drug molecules as well as its conventional topical formulations to get self-permeated to deeper sections of the skin viz dermis and epidermis 4 .…”

Section: Introductionmentioning

confidence: 99%

Design and Evaluation of Ultradeformable Soft Elastic Nano Vesicle Ethosomes for Dermal Delivery

Samnani¹,

Shahwal²,

Bhowmick³

et al. 2012

Int J of Biomed & Adv Res

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Clotrimazole is an antifungal drug for treatment of cutaneous candidiasis infections. However its oral administration is associated with number of drawbacks. The goal of the current investigation is to evaluate the transdermal potential of novel vesicular carrier, ethosomes, bearing Clotrimazole an antifungal having limited transdermal permeation. Clotrimazole loaded ethosomes were prepared, optimized and characterized for vesicular shape and surface morphology, vesicular size, size distribution, entrapment efficiency, and stability. The ethosomal formulation (E63 having 3%phospholipids content and 35% ethanol showing the greatest entrapment (58.75%). Stability study was performed for 120 days. Furthermore ethosomal delivery system could be considered for the treatment of number of dermal infections with better efficiency

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“…Most of the infections documented involve the superficial areas, rarely extending below the sub dermal region. Common skin infections include impetigo (Darmstadt et al 1994), cellulitis, erysipelas (Currie BJ et al2000), folliculitis, furuncles and carbuncles. The predominant strain causing infection varies by geographical location.…”

Section: Introductionmentioning

confidence: 99%

Study of bacteria causing skin infections in school going children in Udupi district;cross-sectional study

K.L¹,

D'Souza²,

C.N³

et al. 2014

International Journal of Pharmacology and Toxicology

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Introduction: Skin infections are a common reason for consultation in primary care and in dermatology practice. The predominant strain causing infection varies by geographical location. The aim of our study was to evaluate various types of bacteria causing skin infections in school going children of Udupi district, Karnataka State, India. Materials and Methods:The study group consisted of school going 236 children in Udupi district. Consent was taken from the parents of respective children to screen for physical examination and to collect skin swabs. Skin swabs were collected from the site of lesions and processed for isolation and identification of the organisms. Antibacterial susceptibility testing was done by Kirby-Bauer disc diffusion test. Results: Swabs were collected from 53 children of 236 (22.45 %) who had abrasions or lesions on skin. Bacterial strains isolated were Staphylococcus aureus (13.2 %) Klebsiella species (1.88%). All the strains of Staphylococcus aureus were susceptible to Methicillin. Erythromycin resistance among these Staphylococcus aureus was 42.85% Discussion: Staphylococcus aureus, the pathogen isolated was 7 (87.5%), this study was in concordance with the study conducted by (Cassandra D. Salgado ET al.2003),who had reported Methicillin resistant strains of 1.3%.Our study did not find any Methicillin resistant Staphylococcus aureus. There was an increased resistance to the erythromycin. This was consistent with the data that had been established in many countries where erythromycin resistance was increasing in community acquired infections. Conclusion: Though Staphylococcus aureus was the common organism isolated from skin swabs, all were sensitive to methicillin,but high prevalence of erythromycin resistance of the Staphylococcus aureus in the community demands proper screening of the isolates for resistance in clinical settings.

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Impetigo: An Overview

Cited by 127 publications

References 88 publications

Role of Group A Streptococcal Virulence Factors in Adherence to Keratinocytes

Role of Group A Streptococcal Virulence Factors in Adherence to Keratinocytes

Design and Evaluation of Ultradeformable Soft Elastic Nano Vesicle Ethosomes for Dermal Delivery

Study of bacteria causing skin infections in school going children in Udupi district;cross-sectional study

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