The role of bacterial skin infections in atopic dermatitis: expert statement and review from the International Eczema Council Skin Infection Group

Atopic dermatitis (AD) patients are massively colonized with Staphylococcus aureus (S. aureus) in lesional and non-lesional skin. A skin infection may become systemic if left untreated. Of interest, the incidence of multi-drug resistant S. aureus (MRSA) in AD patients is higher as compared to a healthy population, which makes treatment even more challenging. Information on the specific genetic background of S. aureus accompanying and/or causing AD flares would be of great importance in terms of possible treatment option development. In this review, we summarized the data on the prevalence of S. aureus in general in AD skin, and the prevalence of specific clones that might be associated with flares of eczema. We put our special interest in the presence and role of staphylococcal enterotoxins as important virulence factors in the epidemiology of AD-derived S. aureus. Also, we summarize the present and potentially useful future anti-staphylococcal treatment.

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MED-12-2103-02

Terapevt (General Physician) ◽

10.33920/med-12-2103-02 ◽

2021 ◽

pp. 17-20

Author(s):

O. Laknitskaya

Keyword(s):

Group A Streptococcus ◽

Interleukin 2 ◽

Skin Infections ◽

Traditional Treatment ◽

Innate And Adaptive Immunity ◽

Recombinant Interleukin 2 ◽

Group A ◽

Bacterial Skin Infections ◽

Methods Of Treatment

Currently, one of the priority medical and social problems of medicine is to optimize the treatment of bacterial skin infections, in particular pyoderma associated with Streptococcus pyogenes-group A streptococcus. The traditional treatment complex, including antibacterial drugs used systemically or topically, selected taking into account individual sensitivity, the presence of pathognomonic microflora, is not always effective due to the increase in antibiotic resistance. Currently implemented methods of immunocorrection, taking into account changes in the immune status in this pathology, corresponding to the clinic of patients, are pathogenetically justified and can be effective. The use of immunomodulatory therapy requires a change in approaches to diagnosis, clarifying the role of factors of innate and adaptive immunity, intercellular mediators and the system of antioxidant protection, allowing to optimize the methods of treatment of this pathology. The use of recombinant interleukin-2 makes up for the lack of interleukin-2 in the blood serum of patients with streptoderma and contributes to the clinical recovery of patients.

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Topical Mupirocin in the Treatment of Bacterial Skin Infections

Drug Intelligence & Clinical Pharmacy ◽

10.1177/106002808602001204 ◽

1986 ◽

Vol 20 (12) ◽

pp. 943-948 ◽

Cited By ~ 4

Author(s):

Jean Rumsfield ◽

Dennis P. West ◽

Iris K. Aronson

Keyword(s):

Eradication Rate ◽

Active Drug ◽

Response To Treatment ◽

Clinical Use ◽

Skin Infections ◽

Dry Skin ◽

Topical Antibiotic ◽

Bacterial Skin Infections

Mupirocin is an investigational topical antibiotic used for treatment and prophylaxis of bacterial skin infections. Mupirocin differs from other antibiotics in its synthesis, structure, and mechanism of action. In vitro, mupirocin possesses antimicrobial activity against staphylococci, streptococci, Hemophilus influenzae, and Neisseria gonorrhoeae. Few studies comparing mupirocin to other topical antibiotics are available. Initial studies comparing mupirocin to inactive vehicle in the treatment of impetigo indicate an overall 92 percent pathogen eradication rate with active drug and 58 percent eradication rate with vehicle. Overall response to treatment of secondary skin infections was favorable in 91 percent of patients treated with mupirocin and 77 percent of those treated with vehicle. Although incidence is not greater than placebo, adverse effects have included pruritus, burning, dry skin, and erythema. Additional trials and clinical use should further help determine the role of mupirocin in the treatment of minor, primary, and secondary skin infections.

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Current and Emerging Topical Antibacterials and Antiseptics: Agents, Action, and Resistance Patterns

Clinical Microbiology Reviews ◽

10.1128/cmr.00112-16 ◽

2017 ◽

Vol 30 (3) ◽

pp. 827-860 ◽

Cited By ~ 90

Author(s):

Deborah A. Williamson ◽

Glen P. Carter ◽

Benjamin P. Howden

Keyword(s):

Bacterial Resistance ◽

Skin Infections ◽

Comprehensive Understanding ◽

Limited Evidence ◽

Resistance Patterns ◽

Topical Antimicrobials ◽

Bacterial Skin Infections ◽

Topical Antimicrobial ◽

Potential Use

SUMMARYBacterial skin infections represent some of the most common infectious diseases globally. Prevention and treatment of skin infections can involve application of a topical antimicrobial, which may be an antibiotic (such as mupirocin or fusidic acid) or an antiseptic (such as chlorhexidine or alcohol). However, there is limited evidence to support the widespread prophylactic or therapeutic use of topical agents. Challenges involved in the use of topical antimicrobials include increasing rates of bacterial resistance, local hypersensitivity reactions (particularly to older agents, such as bacitracin), and concerns about the indiscriminate use of antiseptics potentially coselecting for antibiotic resistance. We review the evidence for the major clinical uses of topical antibiotics and antiseptics. In addition, we review the mechanisms of action of common topical agents and define the clinical and molecular epidemiology of antimicrobial resistance in these agents. Moreover, we review the potential use of newer and emerging agents, such as retapamulin and ebselen, and discuss the role of antiseptic agents in preventing bacterial skin infections. A comprehensive understanding of the clinical efficacy and drivers of resistance to topical agents will inform the optimal use of these agents to preserve their activity in the future.

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RESEARCH OF CERTAIN PATHOGENIC CHARACTERISTICS OF CLINICAL ISOLATES OF STAPHYLOCOCCI OF SKIN BIOME

EUREKA Health Sciences ◽

10.21303/2504-5679.2018.00585 ◽

2018 ◽

Vol 2 ◽

pp. 23-30 ◽

Cited By ~ 1

Author(s):

Yanina Kutasevych ◽

Svetlana Dzhoraeva ◽

Valentina Goncharenko ◽

Yuliia Shcherbakova ◽

Viktoriya Mangusheva ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Atopic Dermatitis ◽

Skin Infection ◽

Clinical Isolates ◽

Healthy Individuals ◽

Intact Skin ◽

Adhesive Properties ◽

Clinical Strains ◽

Antilysozyme Activity

A serious problem in patients with atopic dermatitis (AD) is the frequent attachment of a secondary skin infection. Among the microbes colonizing the skin of patients suffering from AD, S. aureus takes the lead. According to different authors, from the skin of 80–95 % of patients are sown Staphylococcus aureus. The survival of bacteria in a biotope is promoted by the persistent properties of microorganisms. Aim of the research: to determine the adhesive properties and antilysozyme activity of clinical strains of staphylococci isolated from the skin of patients with allergic dermatosis. The study included 50 patients with atopic dermatitis and 20 practically healthy individuals, from which 140 laboratory strains of staphylococci were isolated: 101 strains from patients with AD and 39 control strains. Bacteriological studies to isolate microorganisms and determine a number of pathogenic characteristics were carried out using the methods of classical bacteriology. The severity of antilysozyme activity (ALA) and adhesive properties of strains isolated from affected areas of the skin was significantly higher than in cultures isolated from intact skin areas, both qualitatively and quantitatively. The obtained data made it possible to assume a certain complicating role of these factors on the course of AD.

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Potential role of tedizolid phosphate in the treatment of acute bacterial skin infections

Drug Design Development and Therapy ◽

10.2147/dddt.s30728 ◽

2013 ◽

pp. 243 ◽

Cited By ~ 1

Author(s):

Santiago Grau ◽

Olivia Ferrández ◽

Olatz Urbina ◽

Mercè Espona ◽

Esther Salas ◽

...

Keyword(s):

Potential Role ◽

Skin Infections ◽

Bacterial Skin Infections

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Epidemiology of Skin Infections in Men's Wrestling: Analysis of 2009–2010 Through 2013–2014 National Collegiate Athletic Association Surveillance Data

Journal of Athletic Training ◽

10.4085/1062-6050-52.2.16 ◽

2017 ◽

Vol 52 (5) ◽

pp. 457-463 ◽

Cited By ~ 2

Author(s):

Mackenzie M. Herzog ◽

Melissa A. Fraser ◽

Johna K. Register-Mihalik ◽

Zachary Y. Kerr

Keyword(s):

Student Athletes ◽

Skin Infection ◽

National Collegiate Athletic Association ◽

Athletic Trainers ◽

Surveillance Program ◽

Skin Infections ◽

Infection Rates ◽

Time Loss ◽

Rate Ratios ◽

Bacterial Skin Infections

Context: Our knowledge of the current epidemiology of skin infections among wrestlers is limited. Objective: To analyze and report the epidemiology of skin infections among National Collegiate Athletic Association (NCAA) men's wrestling student-athletes during the 2009–2010 through 2013–2014 academic years. Design: Descriptive epidemiology study. Setting: Aggregate skin infection and exposure data collected by the NCAA Injury Surveillance Program. Patients or Other Participants: Collegiate men's wrestling student-athletes. Main Outcome Measure(s): All viral, bacterial, or fungal skin infections reported by athletic trainers at 17 NCAA programs were analyzed, providing 35 team-seasons of data. Skin infection rates per 10 000 athlete-exposures (AEs), rate ratios, skin infection proportions, and skin infection proportion ratios were calculated. Results: The athletic trainers reported 112 skin infections contracted by 87 student-athletes across 78 720 AEs. The overall skin infection rate was 14.23/10 000 AEs (95% confidence interval [CI] = 11.59, 16.86). Of the skin infections identified, 22.3% (n = 25) were recurrent skin infections. Most skin infections (65.2%) were attributable to 5 team-seasons (range, 11–19 infections). Most skin infections occurred during the regular season (n = 76, 67.9%), were identified during practice (n = 100, 89.3%), and resulted in ≥24 hours' time loss (n = 83, 74.1%). The rate for viral skin infections was 1.72 times the rate for bacterial skin infections (95% CI = 1.09, 2.72) and 2.08 times the rate for fungal skin infections (95% CI = 1.28, 3.39). Fungal skin infections more often resulted in time loss <24 hours compared with all other skin infections (75.0% versus 12.5%; infection proportion ratio = 6.00; 95% CI = 3.30, 10.92). Conclusions: Our findings highlight the contagiousness of skin infections and suggest that skin infection rates may be attributable to high incidences among particular teams.

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Incidence of Bacterial Skin Infections in Libya: A Retrospective Population-Based Study

Iberoamerican Journal of Medicine ◽

10.53986/ibjm.2021.0002 ◽

2020 ◽

Vol 3 (1) ◽

pp. 3-6

Author(s):

Ahmed Atia ◽

◽

Abdulsalam Ashour ◽

Nosaiba Shaban ◽

Fatima Omar ◽

...

Keyword(s):

Bacterial Resistance ◽

Skin Infection ◽

Population Based ◽

Resistance Rate ◽

Resistance Pattern ◽

Skin Infections ◽

Chi Square ◽

E Coli ◽

Antimicrobial Sensitivity ◽

Bacterial Skin Infections

Introduction: The global burden of bacterial skin infection is substantial. We aimed to determine the common pathogens causes skin infections and their antimicrobial resistance pattern. Methods: A retrospective record review of data claimed from the microbiology department at Ber-Ustta Milad skin hospital between Jan 2009 to December 2018 was conducted. The consequence of interest was the antimicrobial sensitivity of bacterial isolates. Chi square was used for statistical analysis. Results: Out of 1,141 collected samples, a total of 455 isolates of different medically-significant bacteria were analyzed. The most common pathogen was S. aureus (97.14%), followed by E. coli (93.71%), and the least common was Shigella (0.57%). From the various inoculated samples, S. aureus and proteus were highly resistant to penicillin (34.3%, 75% respectively) and ampicillin (28.6%, 62.5% respectively). E. coli was highly resistant to ampicillin (45.12%) and penicillin (35.96%), whereas the lowest resistant was against imipenem (3.05%). While, Pseudomonas was highly resistant to ampicillin and augmentin (62.5%), whereas the lowest resistance rate was marked to erythromycin, sulfamethoxazole and imipenem (25%). Ciprofloxacin, gentamicin and nalidixic acid were the only sensitive agents. Conclusions: There is a high burden of bacterial resistance to common antibiotics in our population samples. Recognition of the potential resistant strains of pathogen causing skin infection can help in guiding proper choice of antibiotic therapy.

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Time Course of C-Reactive Protein and Procalcitonin Levels During the Treatment of Acute Bacterial Skin Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy029 ◽

2018 ◽

Vol 5 (3) ◽

Cited By ~ 3

Author(s):

Timothy C Jenkins ◽

Jason S Haukoos ◽

Eleanor Cotton ◽

David Weitzenkamp ◽

Daniel N Frank ◽

...

Keyword(s):

Pilot Study ◽

Treatment Strategy ◽

Time Course ◽

Skin Infection ◽

Serum Levels ◽

Skin Infections ◽

C Reactive Protein ◽

Antibiotic Overuse ◽

Reactive Protein ◽

Bacterial Skin Infections

Abstract In a pilot study of 22 patients with an acute bacterial skin infection, serum levels of C-reactive protein and procalcitonin tended to be elevated at presentation and declined within 3–5 days of treatment. Further study of a biomarker-guided treatment strategy to reduce antibiotic overuse in skin infections is warranted.

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