scholarly journals Opportunities and Obstacles in the Prevention of Skin and Soft-Tissue Infections Among Military Personnel

2019 ◽  
Vol 184 (Supplement_2) ◽  
pp. 35-43
Author(s):  
Eugene V Millar ◽  
Carey D Schlett ◽  
Natasha N Law ◽  
Timothy J Whitman ◽  
Michael W Ellis ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Military Personnel ◽  
Vaccine Trial ◽  
Soft Tissue Infections ◽  
Phase 2 ◽  
Training Population ◽  
Fort Benning ◽  
The Military

Abstract Introduction Skin and soft-tissue infections (SSTIs) are an important cause of infectious disease morbidity among military populations. Due to the high direct and indirect costs associated with SSTIs, particularly with methicillin-resistant Staphylococcus aureus (MRSA) infections, there remains a critical need for the development and evaluation of SSTI prevention strategies among high-risk military personnel. Herein, we review efforts of the Infectious Disease Clinical Research Program (IDCRP) related to the prevention of SSTIs in the military. Methods The IDCRP of the Uniformed Services University has conducted clinical research protocols on SSTI epidemiology and prevention among military personnel since 2009. Observational studies have examined the epidemiology of Staphylococcus aureus colonization and SSTI in training and deployment settings. Two randomized controlled trials of personal hygiene strategies for SSTI prevention at Marine Corps Base Quantico (Virginia) and Fort Benning (Georgia) were performed. Lastly, two vaccine trials have been conducted by the IDCRP, including a Phase 2 S. aureus vaccine trial (currently ongoing) among military trainees. Results Military recruits and deployed personnel experience an intense and prolonged exposure to S. aureus, the major causative agent of SSTI. The burden of S. aureus colonization and SSTI is particularly high in military trainees. Hygiene-based trials for S. aureus decolonization among military trainees were not effective in reducing rates of SSTI. In January 2018, the IDCRP initiated a Phase 2 S. aureus vaccine trial among the US Army Infantry training population at Fort Benning. Conclusions In the military, a disproportionate burden of SSTIs is borne by the recruit population. Strategies relying upon routine application of agents for S. aureus decolonization have not been effective in preventing SSTIs. A novel S. aureus vaccine candidate is being currently evaluated in a military training population and may represent a new opportunity to prevent SSTIs for the military.

scholarly journals Role of Antibodies in Protection Elicited by Active Vaccination with Genetically Inactivated Alpha Hemolysin in a Mouse Model of Staphylococcus aureus Skin and Soft Tissue Infections

2014 ◽  
Vol 21 (5) ◽  
pp. 622-627 ◽  
Author(s):  
Christopher P. Mocca ◽  
Rebecca A. Brady ◽  
Drusilla L. Burns
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Murine Model ◽  
Bacterial Colonization ◽  
Passive Immunization ◽  
The United States ◽  
Soft Tissue Infections ◽  
Content Type ◽  
Alpha Hemolysin ◽  
Active Vaccination

ABSTRACTDue to the emergence of highly virulent community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) infections,S. aureushas become a major threat to public health. A majority of CA-MRSA skin and soft tissue infections in the United States are caused byS. aureusUSA300 strains that are known to produce high levels of alpha hemolysin (Hla). Therefore, vaccines that contain inactivated forms of this toxin are currently being developed. In this study, we sought to determine the immune mechanisms of protection for this antigen using a vaccine composed of a genetically inactivated form of Hla (HlaH35L). Using a murine model of skin and soft tissue infections (SSTI), we found that BALB/c mice were protected by vaccination with HlaH35L; however, Jh mice, which are deficient in mature B lymphocytes and lack IgM and IgG in their serum, were not protected. Passive immunization with anti-HlaH35L antibodies conferred protection against bacterial colonization. Moreover, we found a positive correlation between the total antibody concentration induced by active vaccination and reduced bacterial levels. Animals that developed detectable neutralizing antibody titers after active vaccination were significantly protected from infection. These data demonstrate that antibodies to Hla represent the major mechanism of protection afforded by active vaccination with inactivated Hla in this murine model of SSTI, and in this disease model, antibody levels correlate with protection. These results provide important information for the future development and evaluation ofS. aureusvaccines.

Infective skin conditions in an adult sea-going population

2014 ◽  
Vol 100 (1) ◽  
pp. 49-57
Author(s):  
J Tanzer ◽  
A Macdonald ◽  
S Schofield
Keyword(s):  
Primary Care ◽  
Staphylococcus Aureus ◽  
Military Personnel ◽  
Family Doctor ◽  
Soft Tissue Infections ◽  
Close Proximity ◽  
Skin Conditions ◽  
The Uk ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

AbstractInfective skin conditions represent a significant element of the caseload for sea-going and shore-side clinicians. They are common within the wider military setting due to the frequent requirement to live in close proximity to others in conditions which favour the spread of skin and soft tissue infections (SSTI) (1, 2). Within the UK civilian population, 24% of individuals see their family doctor for skin conditions each year, accounting for 13 million primary care consultations annually. Of these, almost 900,000 were referred to dermatologists in England in 2009-2010 and resulted in 2.74 million secondary care consultations (3).Several recent articles have highlighted the problem of Panton-Valentine Leukocidin Staphylococcus aureus (PVL-SA) infection and carriage in sailors on submarines, and soldiers deployed to Afghanistan (4, 5). However, the majority of published articles relate to land-based military personnel. This article aims to provide an overview of the most common infective skin conditions presenting among Naval personnel (based on the authors’ experience), illustrated by several case studies, together with an approach to their diagnosis and management.

scholarly journals Community acquired MRSA infections in a paediatric population in Greece

2005 ◽  
Vol 10 (5) ◽  
pp. 7-8 ◽  
Author(s):  
S Vourli ◽  
D Perimeni ◽  
A Makri ◽  
M Polemis ◽  
A Voyiatzi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Paediatric Population ◽  
Pfge Pattern ◽  
Soft Tissue Infections ◽  
Paediatric Hospital ◽  
Mrsa Strains ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

We investigated the characteristics of 20 community acquired methicillin resistant Staphylococcus aureus (MRSA) strains isolated in a paediatric hospital in Athens. Eighteen of these, all isolated from skin and soft tissue infections, carried the Panton-Valentine leukocidin (PVL) determinants. They all were found resistant to fusidic acid, tetracycline and kanamycin, and displayed a PFGE pattern identical to that of the well-described ST80 CA-MRSA clone circulating in various European countries.

scholarly journals ST93-Queensland community-acquired meticillin-resistant Staphylococcus aureus clone in France: outbreak in a scout camp and sporadic cases, July to August 2012

2012 ◽  
Vol 17 (44) ◽  
Author(s):  
T X Nhan ◽  
M Bes ◽  
H Meugnier ◽  
L Toko ◽  
G Julienne ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Soft Tissue Infections ◽  
Sporadic Cases ◽  
Panton Valentine Leukocidin ◽  
Valentine Leukocidin

We describe the occurrence in France of a Panton-Valentine leukocidin (PVL)-positive meticillin-resistant Staphylococcus aureus (MRSA) ST93 clone, a predominant community-acquired (CA)-MRSA in Australia. In July to August 2012, an outbreak in a scout camp (n=3) and sporadic cases (n=2) of skin and soft tissue infections were reported. Investigations suggested importation of the clone through travel and onward transmission. This illustrates the epidemic potential of this lineage and the role of travellers in the spread of PVL-positive CA-MRSA.

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