Prevention of Recurrent Staphylococcal Skin Infections

Abstract

Synopsis Staphylococcus aureus infections pose a significant health burden. The emergence of community-associated methicillin-resistant S. aureus has resulted in an epidemic of skin and soft tissue infections (SSTI), and many patients experience recurrent SSTI. As S. aureus colonization is associated with subsequent infection, decolonization is recommended for patients with recurrent SSTI or in settings of ongoing transmission. S. aureus infections often cluster within households and asymptomatic carriers serve as reservoirs for transmission; therefore, a household approach to decolonization is more effective than measures performed by individuals alone. Other factors, such as environmental surface contamination, may also be considered. Novel strategies for the prevention of recurrent SSTI are needed.

A prospective observational cohort study in primary care practices to identify factors associated with treatment failure in Staphylococcus aureus skin and soft tissue infections

“…In the U.S., approximately 80–90% of SSTIs are due to S. aureus [2, 3]. Moreover, treatment failure is common after an initial S. aureus SSTI episode; recurrence rates have exceeded 50% in some populations [4]. Treatment failure may be multifactorial and can be associated with host factors, disease management, and pathogen features.…”

Photodynamic inactivation of bacteria to decolonize meticillin-resistant Staphylococcus aureus from human skin

“…Most typically, aerobic Gram‐positive cocci such as Staphylococcus serve as the contaminant, with resistant pathogens such as MRSA representing an increasing proportion of infections in recent years . Such infections play a major role in patients undergoing haemodialysis, after total hip and knee arthroplasty, cardiac surgery, recurrent staphylococcal skin infections, especially for patients with atopic dermatitis and soft tissue infections . Decolonization is considered important in critical care medicine .…”

Corrigendum to ‘Panton-Valentine Leucocidin (PVL) Staphylococcus aureus a position statement from the International Society of Chemotherapy’ [International Journal of Antimicrobial Agents 51/1 (2018) 16-25]

“…Limited data support performing initial eradication in all household members , however this can be offered. Quarterly decolonization has been proposed in refractory or recurrent PVLPSA colonization and infections among families [67]. Further studies are required to support these suggestions and proposals.…”

“…In such cases treatment of underlying conditions (skin disease or change of devices) should be optimized and simultaneous treatment of the index patient and household contacts is recommended. Extended decolonization regimens over three months with intranasal mupirocin on five consecutive days each month and antimicrobial baths two to three times per week have been proposed [67]. Further studies are required to support this approach.…”