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At least 19 recordsLinked to original sources
PubMed1999

Epidemiology and prevention of group A streptococcal infections: acute respiratory tract infections, skin infections, and their sequelae at the close of the twentieth century.

Infections of the upper respiratory tract and skin due to group A Streptococcus are common, and the organism is highly transmissible. In industrialized countries and to some extent in developing countries, control efforts continue to emphasize that group A streptococcal pharyngitis should be properly diagnosed and appropriately treated. In developing countries and in indigenous populations where the burden of group A streptococcal diseases appears greatest, the epidemiology is less completely defined and may differ from that in industrialized countries. There is a need for accurately collected epidemiological data from developing countries, which may also further clarify the pathogenesis of group A streptococcal infections and their sequelae. While proper treatment of group A streptococcal pharyngitis continues to be essential in all populations, it may be appropriate in developing countries to consider additional strategies to reduce rates of pyoderma.

Acute Disease↗
PubMed2005

Soil-transmitted helminth infection, skin infection, anaemia, and growth retardation in schoolchildren of Taveuni Island, Fiji.

AIM: To estimate the prevalence of hookworm, ascaris, and trichuris infection; as well as anaemia, growth retardation, scabies, and impetigo; in schoolchildren of Taveuni Island, Fiji. METHODS: Schoolchildren from five villages on Taveuni Island were examined and had their haemoglobin concentration measured on a finger-prick blood sample. In addition, they had a faecal sample examined for the presence of helminth ova. RESULTS: 258 children aged 5-15 years were surveyed. The overall prevalence of infection was: hookworm 14%, ascaris 33%, trichuris 17%, scabies 32%, and impetigo 2%. Eight percent of children were anaemic, while 8% and 6% of children were on or below the third centile for weight and height respectively. CONCLUSIONS: The relatively low overall prevalence of hookworm infection and of anaemia suggests that regular anthelminthic treatment of schoolchildren would only provide modest health benefits. Further study is needed to identify the reasons why Taveuni Island schoolchildren weigh less than expected for their age.

Adolescent↗
PubMed2001

Common viral and fungal skin infections.

Skin infections account for a significant portion of dermatologic diseases, often resulting in, or as a consequence of a disruption in the skin's integrity. This paper covers the presentation, diagnosis, and treatment of the more common viral and fungal skin infections. The viral infections presented in this paper include herpes simplex virus, herpes zoster, condyloma acuminata, and molluscum contagiosum. The fungal infections presented include tinea pedis, tinea cruris, tinea capitis, tinea unguium, tinea versicolor, and candidiasis. Once a diagnosis is made, treatment with appropriate antifungal, antiviral, destructive, or immune modifying therapies can be instituted.

Candidiasis, Cutaneous↗
PubMed2001

Common bacterial skin infections.

Skin infections account for a significant portion of dermatologic disease, often resulting in or as a consequence of a disruption in the skin's integrity. This article covers the presentation, diagnosis, and treatment of the more common bacterial infections. The infections presented herein include impetigo, ecthyma, folliculitis, carbuncles/furuncles, cellulitis, toxic shock syndrome, and ecthyma gangrenosum. Once a diagnosis is made, treatment is based on the culture and antibiotic sensitivities of the offending organisms.

Anti-Bacterial Agents↗
PubMed2004

Activity of nadifloxacin (OPC-7251) and seven other antimicrobial agents against aerobic and anaerobic Gram-positive bacteria isolated from bacterial skin infections.

BACKGROUND AND METHODS: The in vitro activity of nadifloxacin (OPC-7251), a novel topical fluoroquinolone, was assessed and compared with those of ofloxacin, oxacillin, flucloxacillin, cefotiam, erythromycin, clindamycin, and gentamicin against 144 Gram-positive bacteria: 28 Staphylococcus aureus, 10 Streptococcus spp., 68 coagulase-negative staphylococci (CNS), 36 Propionibacterium acnes, and 2 Propionibacterium granulosum strains. All strains originated from bacterial-infected skin disease and were isolated from patients with impetigo, secondary infected wounds, folliculitis and sycosis vulgaris, and impetiginized dermatitis. In vitro susceptibility of all clinical isolates was tested by agar dilution procedure and minimum inhibitory concentrations (MICs) were determined. RESULTS: Nadifloxacin was active against all aerobic and anaerobic isolates. MIC(90) (MIC at which 90% of the isolates are inhibited) was 0.1 microg/ml for S. aureus, 0.78 microg/ml for both Streptococcus spp. and CNS, and 0.39 microg/ml for Propionibacterium spp. On the other hand, resistant strains with MICs exceeding 12.5 mug/ml were found in tests with the other antibiotics. For both CNS and Propionibacterium acnes, MIC(90) values > or =100 microg/ml were demonstrated for erythromycin. Ofloxacin, cefotiam, erythromycin, clindamycin and gentamicin exhibited MIC(90) values < or =1 microg/ml for some bacterial species tested. Both oxacillin and flucloxacillin were active against all investigated bacterial species with MIC(90) values < or =1 microg/ml. CONCLUSION: In summary, nadifloxacin, a topical fluoroquinolone, was found to be highly active against aerobic and anaerobic bacteria isolated from patients with infected skin disease, and seems to be a new alternative for topical antibiotic treatment in bacterial skin infections.

Administration, Topical↗
PubMed1993

Intervention to discontinue parenteral antimicrobial therapy in hospitalized patients with urinary tract infection, skin and soft tissue infection, or no evident infection.

OBJECTIVES: In a previous study, we found that unsolicited recommendations to physicians of medically stable patients with pneumonia to suspend parenteral antimicrobials shortened hospital length of stay (LOS) significantly. In this study, we made similar recommendations to physicians treating patients with different indications for parenteral antimicrobials, to examine the effect on LOS. METHODS: A nurse-interventionist presented randomly assigned physicians with nonconfrontational suggestions to discontinue parenteral antimicrobials by substituting comparable oral antimicrobials or stopping treatment. Patients were being treated for urinary tract infection, skin infection, or no evident infection. Blinded observers evaluated in-hospital and 30-day postdischarge patient courses. Methodologies were identical to the previous study. RESULTS: There were 70 physician-patient episodes (49 intervened episodes, 21 control episodes). In 44 episodes (90%), compliant physicians discontinued parenteral antimicrobials. Compared to a median postrandomization LOS of 2.5 days (range, 0 to 40.5) for 21 patients of control physicians, the corresponding LOS for 44 patients of compliant physicians was two days (range, 0 to 8; P = 1.0), and for five patients of noncompliant physicians, five days (range, 3 to 11; P = 0.04). The combined occurrence of all adverse events detected in this and the previous study was 11% for patients of control physicians, compared to 14% for patients of compliant physicians (P = 0.2), and 19% for patients of noncompliant physicians (P < 0.05). CONCLUSIONS: For patients of compliant physicians hospitalized with urinary tract infection, skin and soft tissue infection, or no evident infection, cessation of parenteral antimicrobials did not significantly shorten LOS, due to brief LOS of patients of control physicians. Patients of noncompliant physicians experienced more adverse events and prolonged LOS. The appropriateness of routine continuous use of parenteral antimicrobials in medically stable inpatients is questioned.

Aged↗
PubMed2000

[The efficacy of antiviral antibiotic 17997 on treatment of HSV-1 infected guinea pig skin infection].

OBJECTIVE: To study the treatment efficacy of antiviral antibiotic 17997 against HSVl infected guinea pig skin infection. METHODS: Guinea pig skin was infected by HSV1. 24hrs or 48hrs of post infection local treatment of 0.3% 17997 cream was started, tid for five days. In the mean time, acyclovir treatment, cream treatment and virus control were included. RESULTS: Local treatment of 0.3% 17997 cream showed therapeutic effects, it reduced the average scores of skin lesion, accelerated crusting-time and healing-time. CONCLUSIONS: 0.3% 17997 cream showed significant treatment efficacy when compared with cream and virus controls by reducing skin lesion scores and healing-time. The treatment efficacy of 3.0% acyclovir cream was a little bit better than 0.3% 17997 cream.

Acyclovir↗
PubMed1997

Study of use of cefdinir versus cephalexin for treatment of skin infections in pediatric patients. The Cefdinir Pediatric Skin Infection Study Group.

Three hundred ninety-four patients, aged 6 months to 12 years, entered a multicenter, randomized, controlled, investigator-blind study comparing cefdinir, 7 mg/kg of body weight twice a day, with cephalexin, 10 mg/kg four times a day, each given for 10 days. The most common infections treated were impetigo and secondary infection of preexisting dermatitis. The most common pathogens isolated were Staphylococcus aureus and Streptococcus pyogenes. Two hundred thirty-one patients were microbiologically evaluable. Microbiologic eradication rates were 164 of 165 pathogens (99.4%) in the cefdinir group and 152 of 156 pathogens (97.4%) in the cephalexin group (P = 0.14). Clinical cure rates were 116 of 118 patients (98.3%) in the cefdinir group and 106 of 113 patients (93.8%) in the cephalexin group (P = 0.056). Sixteen percent of cefdinir patients and 11% of cephalexin patients experienced adverse events (P = 0.11), the most common being diarrhea, which affected 8% of the cefdinir group and 4% of the cephalexin group. Cefdinir appears to be an effective and well-tolerated agent for the treatment of uncomplicated skin and skin structure infections in pediatric patients.

Cefdinir↗
PubMed2000

Adherence characteristics and susceptibility to antimicrobial agents of Staphylococcus aureus strains isolated from skin infections and atopic dermatitis.

We examined the adherence characteristics and susceptibility to various antimicrobial agents of 130 strains of Staphylococcus aureus isolated from infective skin lesions and 135 strains of S. aureus isolated from non-infective eczematous lesions of atopic dermatitis (AD) patients. The isolation rate of methicillin-resistant S. aureus (MRSA) was 27.7% in strains from clinical sources excluding AD and 31.1% in those from AD. Coagulase type II strains were most frequently observed in MRSA strains isolated from all sources excluding AD, and coagulase type III strains were most frequently observed in those isolated from AD. We proposed that antimicrobial treatment for AD patients should be carefully designed to prevent MRSA infection. Plasma coagulation ability was lowest in S. aureus strains isolated from abscesses, suggesting that the lower production of fibrin observed in abscesses may assist the infiltration of neutrophils into skin tissues and that a decrease in plasma coagulation ability may enable abscess formation. Adherence to polypropylene tubes with slime production was most evident in S. aureus strains isolated from felon and least evident in those isolated from cellulitis and lymphangitis. Tube adherence was characteristic of the S. aureus strains attached to superficial skin tissues, but not necessarily for strains that had infiltrated the deep skin tissues. Fusidic acid demonstrated significant antimicrobial activity against the MRSA strains, but rifampicin was the strongest antimicrobial agent.

Anti-Bacterial Agents↗
PubMed1985

[Immunity of the skin--infection and percutaneous immunization of rabbits with E. coli ATCC 13676].

After intracutaneous infection of rabbits with a suspension of E. coli which was followed by a transient local inflammation, the local and systemic immune responses were determined using the lymphocyte stimulation test (LTT) and the hemolysis plaque assay (HPA). Lymphocytes of the lymphatic system draining the infected skin area and blood lymphocytes were used. With lymphocytes derived from the local lymph nodes, a substantial increase of specific stimulation in the LTT was detected beginning at day 3 after infection and lasting up to the termination of the experiment (3 weeks). Blood lymphocytes were stimulated at a lower level: The activity showed a peak at day 4 and an elevated level only during a 10-day period. After the intracutaneous infection with E. coli, increasing numbers of antibody-releasing lymph node cells were detected in the HPA. The antibody-secreting cells of the IgM and IgG classes clearly showed an increasing specificity for E. coli lipopolysaccharide coupled to sheep red blood cells. As with the LTT, the highest activities (values of specificity and number of plaque-forming lymphocytes) were observed at the end of the experimental period. An emulsified preparation of a heat-inactivated E. coli culture (E. coli-BKS) which had been applied locally onto the artificially altered skin evoked a similar immunological response after a 2 or 3-weeks treatment. In such animals an increased activity of lymph node cells could be registered by LTT and HPA as compared to reactions from placebo-treated control animals. However, the topical immunization with nonviable E. coli stimulated not only lymphocytes which produced antibodies directed specifically against E. coli lipopolysaccharide as demonstrated by the HPA. An increased number of lymphocytes reacted even with native sheep red blood cells. This observations is discussed in respect of a polyclonal B-cell activation by lipopolysaccharide of the E. coli-BKS.

Animals↗
PubMed2003

An outbreak of community-onset methicillin-resistant Staphylococcus aureus skin infections in southwestern Alaska.

OBJECTIVE: We investigated a large outbreak of community-onset methicillin-resistant Staphylococcus aureus (MRSA) infections in southwestern Alaska to determine the extent of these infections and whether MRSA isolates were likely community acquired. DESIGN: Retrospective cohort study. SETTING: Rural southwestern Alaska. PATIENTS: All patients with a history of culture-confirmed S. aureus infection from March 1, 1999, through August 10, 2000. RESULTS: More than 80% of culture-confirmed S. aureus infections were methicillin resistant, and 84% of MRSA infections involved skin or soft tissue; invasive disease was rare. Most (77%) of the patients with MRSA skin infections had community-acquired MRSA (no hospitalization, surgery, dialysis, indwelling line or catheter, or admission to a long-term-care facility in the 12 months before infection). Patients with MRSA skin infections were more likely to have received a prescription for an antimicrobial agent in the 180 days before infection than were patients with methicillin-susceptible S. aureus skin infections. CONCLUSIONS: Our findings indicate that the epidemiology of MRSA in rural southwestern Alaska has changed and suggest that the emergence of community-onset MRSA in this region was not related to spread of a hospital organism. Treatment guidelines were developed recommending that beta-lactam antimicrobial agents not be used as a first-line therapy for suspected S. aureus infections.

Adolescent↗
PubMed1985

The aerobic bacteriology of infected skin lesions in children of the Eastern Highlands Province.

Of 480 children studied, the relative frequency of skin infections divided into three categories were: score 266 (55%), infected scabies 164 (34%) and tropical ulcers 50 (10%). Infected scabies was more prevalent in the less than 2 year age group and tropical ulcers were commonest in the 9-12 year age group and these differences were significant. The majority of lesions occurred on the lower extremities with the trunk the least commonly affected area. No significant differences were found in different age groups between males and females. Beta haemolytic streptococci (95%), Staphylococcus aureus (83%), Corynebacterium diphtheriae (72%) and Corynebacterium haemolyticum (35%) were the major bacteria isolated. Beta haemolytic streptococci were the most prevalent in infected scabies and least in tropical ulcers and these differences were significant. Three major Lancefield groups were isolated: group A (61%), group C (19%) and group G (19%). The distribution of these groups were unequal with group A most common in infected scabies but rarely seen in tropical ulcers. Groups C and G were found more commonly in tropical ulcers than the other two groups of lesions and these differences were significant. Multiple populations of beta haemolytic streptococci in a single lesion were seen in 19% of children. Less than one third of Streptococcus pyogenes were M typable and of these 18% were known nephritogenic serotypes. Staphylococcus aureus was significantly more common in infected scabies and least common in tropical ulcers. The prevalence of Vincent's organisms in tropical ulcers (74%) was significantly higher than scores (9%) and infected scabies (1%). The isolation rate of Corynebacterium diphtheriae was significantly higher in infected scabies than the other two groups. The most common biotype isolated was var mitis (72%). Only 2% of isolates were toxigenic. Corynebacterium haemolyticum was isolated significantly more frequently in tropical ulcers than the other lesions. All major bacteria, excluding betalactamase-producing Straphylococcus aureus, were uniformly sensitive to penicillin. Methicillin resistance was found in 1% of Staphylococcus aureus isolates and is reported here for the first time in this country. These isolates were also multiply resistant to erythromycin, chloramphenicol and tetracycline.

Anti-Bacterial Agents↗
PubMed2003

Assessment of Streptococcus pyogenes microcolony formation in infected skin by confocal laser scanning microscopy.

BACKGROUND: Streptococcus pyogenes and Staphylococcus aureus are often simultaneously detected from many cases of non-bullous impetigo with atopic dermatitis. OBJECTIVES: Using confocal laser scanning microscopy (CLSM), to investigate formation of S. pyogenes microcolonies in skin lesions. METHODS: The S. pyogenes cells in the stationary growth phase alone were strongly stained with fluorescein isothiocyanate-concanavalin A (FITC-ConA), and this staining was reduced by pretreatment with amylase. Although the components of sugars in glycocalyx produced by S. pyogenes cells are unknown, we suggested that the materials stained by FITC-ConA were consistent with the presence of ConA-reactive sugars in glycocalyx produced by S. pyogenes cells. RESULTS: S. pyogenes cells associated with streptococcal impetigo skin and croton-oil inflamed mouse skin formed microcolonies encircled by materials (glycocalyx) that stained strongly with FITC-ConA, and these findings were consistent with those in biofilms. In croton-oil inflamed mouse skin, polymorphonuclear leukocytes (PMNs) infiltrated to just below the epidermis in the cefdinir-treated group but only to the middle dermis in the cefdinir-non-treated group. In this case S. pyogenes and S. aureus cells formed separate microcolonies and existed independently in the outer walls of pustule lesions of streptococcal impetigo. CONCLUSION: In skin infections, S. pyogenes and S. aureus formed aggregates of microcolonies (similar to that in biofilms) encircled by glycocalyx, which can make the infection hard to eradicate using an antimicrobial agent alone. The effect of conventional antimicrobial agents against biofilm is mainly due to the increase of the invasion of PMNs into the biofilm.

Adolescent↗
PubMed2000

[Complications of percutaneous endoscopic gastrostomy in the elderly: local skin infection and respiratory infection].

We investigated post-operative management of acute complications of percutaneous endoscopic gastrostomy (PEG) which often caused respiratory infections and local skin infections. The subjects were a total of 341 patients (male 131, female 210, and the mean age was 80.3), they were classified into six groups by method of feeding and use of antibiotics. Patients were divided into three groups based on the time that feeding was started. In Group I, enteral feeding was not started within the first five days. In Group II, sterilized enteral feeding (lactated Ringer's solution for intravenous infusion) using sterilized intravenous infusion kit started within 24 hours after the procedure, and in Group III, feeding of the usual enteral formula started within 24 hours after the procedure. And as for the using of antibiotics, they were also divided into two groups, antibiotics administered[AB (+)] and no antibiotics administered[AB (-)]. Thus, the patients were divided into six groups according to the time of starting nutrition and the use of antibiotics. The rates of incidence of acute respiratory infections and local skin infections in the six groups were compared by the chi-square test and differences in the rates of incidence of complication were also compared between two PEG methods; the Pull/Push method and the Introducer method. The frequency of local skin infection in Group III was significantly higher than in Group I and Group II. As for the PEG methods, the frequency of local skin infection in the Pull/Push method was significantly higher than Introducer methods. Acute respiratory infections occurred significantly less in the AB (+) group than in the AB (-) group. Postoperative administration of antibiotics would seem to be appropriate for prophylaxis of respiratory infection in elderly patients after PEG. On the other hand, local skin infections are not related to administration of antibiotics, and are highly related to the method of feeding. We concluded that nutrition of sterilized enteral feeding immediately after operation using a sterilized intravenous infusion kit and administration of antibiotics are advisable to prevent major complications in elderly patients.

Aged↗
PubMed2005

Fungal infections of the skin: infection process and antimycotic therapy.

Dermatomycoses are among the most widespread and common superficial and cutaneous fungal infections in humans. These typically nonfatal conditions are difficult to treat, especially infections of the nail. Dermatomycoses are caused by filamentous fungi such as Trichophyton, Microsporum or Epidermophyton species. These filamentous fungi have a high affinity for keratin, an important component of hair, skin and nails, which are the primary areas of infection by dermatophytes. The antifungal agents currently marketed for dermatomycoses are mainly inhibitors of ergosterol biosynthesis, except for griseofulvin, which interferes with the cytoplasmic and nuclear microtubular system. Three different types of inhibitors of the ergosterol biosynthetic pathway have been proven to be effective in clinic: the azoles (e.g. topical miconazole and topical/oral ketoconazole, itraconazole and fluconazole), the allylamines (e.g. terbinafine) and morpholines (amorolfine). Even today more effective antifungal azoles with less adverse effects and short-term therapy are deemed necessary to treat dermatophytosis. A promising novel triazole compound in this respect is R126638, which showed potent in vitro and in vivo activity.

Allylamine↗
PubMed1989

[Bacterial skin flora, host defense and skin infections].

Resident skin flora consists of coagulase-negative staphylococci, micrococci, aerobic and anaerobic coryneform organisms (i.e. propionibacterium acnes) as well as gram-negative rods (i.e. acinetobacter). Their growth is favoured by increased temperature and humidity and modified by body location, age, sex and chronic diseases (i.e. diabetes mellitus). Occupation, hospitalization, soaps and disinfectants as well as medications exert promoting and inhibiting influences, too. In addition, environment gains significant importance due to trauma and implants as well as contact with animals, infected persons and carriers. Whereas bacteria attach by adhesins and succeed other bacteria by factors of pathogeneity such as exotoxins, exoenzymes, bacteriocins and various interference mechanisms, skin exerts its resistance and defense by means of the intact horny layer, proliferation and desquamation, lipids and fatty acids as well as sweat, in addition, by means of IgA and the specific skin immune system with complex interactions between Langerhans-, TH-, TS- and cytotoxic T-cells, interleukins and cytokines. Furthermore the non-specific defense system (complement, NK-cells, granulocytes, mononuclear phagocytic system, inflammation) is involved. Finally, skin infections caused by resident bacterial flora are briefly discussed.

Bacteria↗