Complicated Skin and Soft Tissue Infection
Key Points
Key Points
Complicated infections are:
- Those involving deeper soft tissues necessitating surgical intervention, such as infected ulcers, burns, major abscesses, or an underlying disease state that complicates the response to treatment (eg, peripheral arterial disease, chronic kidney disease, diabetes mellitus)
- Superficial infections or abscesses in sites, such as the rectal area, where the risk of anaerobic or gram-negative pathogen involvement is higher.
- Overall, Staphylococcus aureus is the pathogen most frequently isolated from complicated SSTIs.
- This pathogen typically is associated with the production of virulence factors not common to methicillin-sensitive S. aureus (MSSA) isolates or to hospital-associated HA-MRSA isolates, including the Panton-Valentine leukocidin (PVL) toxin.
Assessment
...ssessmen...
...ecrotizing Celluli...
...superficially spreading infections involving...
...iotic therapy: for moderate to severe i...
...failures may occur if β-lactam agents...
...thesis-inhibitory agents alone—eg, clin...
...olide resistance among streptococc...
...r regimens that may be considered are a...
...bscess...
...le abscesses may respond to incision and draina...
...ex abscesses and those with substantial celluliti...
...uate response to therapy should prompt evaluation...
...ntibiotic therapy should be directed...
...gents directed at CA-MRSA should be considered in...
...ted polymicrobial infections should be managed...
Necrotizing Skin and Soft Tissue Infecti...
...gnosis:...
...Score Calculator...
...n diagnosis increase both the morbidity...
...f gas in soft tissues is specific for necr...
...tomography and MRI improve the detection of sof...
...aphic findings of tissue fluid and edem...
...ical features strongly suggestive of n...
...ratory values predictive of the pres...
...atment...
...ate antibiotic coverage of inciting pat...
...y surgical debridement improves outcome. (1, C)68...
...h no randomized or important non-rand...
...ent re-evaluation or return to the operat...
...likely pathogens differ depending on the cli...
...ysiology, and previous exposure to ant...
...fections are more frequently polymicrobial and m...
...ssuming that relevant pathogens are c...
...ng resistance of gram-negative bacilli to am...
...erous combinations of agents proba...
...ressive Soft Tissue Infections...
...apidly progressive soft tissue infections can...
...ections require early and aggressive antibiotic...
...therapy that includes protein synthesis...
Selecting a Treatment Regimen
...lecting a Treatment Regime...
...1. Non-Necrotizing β-Hemolytic Strep...
...ure 2. Complicated Abscesses...
Figure 3. Necrotizing Skin and Soft Tiss...
...4. Staphylococcus aureus– MSSA & MRSA*...
...e 5. Necrotizing Group A Streptococcal Infect...
...Clostridial Infections...
...7. VibrioInfection...
...able 1. Antibiotic Treatment of Co...
...rganisms Recovered from 198 Consecuti...