Seasonal Variation in Hand and Upper Limb Soft Tissue Infections

2019 ◽  
Vol 24 (02) ◽  
pp. 189-194
Author(s):  
Robert Miller ◽  
Sarah Pywell ◽  
James Chan ◽  
Simon McCluney ◽  
Tim Halsey
Keyword(s):  
Antibiotic Resistance ◽  
Seasonal Variation ◽  
Soft Tissue ◽  
Upper Limb ◽  
Soft Tissue Infections ◽  
Significant Difference ◽  
Significant Disability ◽  
International Data ◽  
Post Hoc ◽  
Culture Positive

Background: Hand and upper limb soft tissue infections result in significant disability and loss of productivity. Many infections have been shown to follow a seasonal variation, however little is known about this is the context of upper limb soft tissue infections. We aimed to evaluate seasonal variation in acute bacterial, hand and upper limb skin and soft-tissue infections, and correlate findings with key environmental variables. Methods: Hand and upper limb soft tissue infection cases from 2006–2016 were retrieved from a single UK center. Cases were reviewed for microbiology culture and sensitivity. Correlation between cases and season, temperature and humidity was assessed. Results: 206 cases were identified for inclusion. Specimens were sent for microbiology in 76.4% of cases. Of these 78.9% were culture positive, 47.6% exhibited antibiotic resistance and 16.9% were multi-resistant. There was a significant difference between season and culture positive cases, with significantly more culture positive cases in the summer vs. winter on post-hoc analysis (p = 0.004). There was a significant positive correlation between higher temperatures and number of culture positive cases (r = 0.75). There was no significant correlation between temperature and antibiotic resistance (r = 0.5) or between humidity and culture positive cases (r = −0.42). Conclusions: This study demonstrates a seasonal variation in hand and upper limb infections, with a significant correlation between infection rates and ambient temperature. Appreciating seasonal variability of these infections could prove beneficial for surgical planning, public health recommendations and antibiotic guidelines. However, further international data is needed to understand potential mechanisms involved.

Soft tissue infections of the hand and upper limb

2021 ◽  
pp. 351-360
Author(s):  
Sophie Collier ◽  
Barbara Jemec
Keyword(s):  
Soft Tissue ◽  
Antibiotic Prophylaxis ◽  
Upper Limb ◽  
Soft Tissue Infections ◽  
Comprehensive Overview ◽  
Operative Control

This chapter offers a comprehensive overview of the management of soft tissue infections of the upper limb, including operative control, antibiotic prophylaxis, and treatment in acute, chronic, and atypical cases.

Management of superficial and deep-seated Staphylococcus aureus skin and soft tissue infections in sub-Saharan Africa: a post hoc analysis of the StaphNet cohort

Infection ◽  
2018 ◽  
Vol 46 (3) ◽  
pp. 395-404 ◽  
Author(s):  
Abraham Alabi ◽  
Theckla Kazimoto ◽  
Marthe Lebughe ◽  
Delfino Vubil ◽  
Patrick Phaku ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Sub Saharan Africa ◽  
Soft Tissue Infections ◽  
Post Hoc Analysis ◽  
Sub Saharan ◽  
Post Hoc

Antibiotic Resistance in Diabetic Foot Soft Tissue Infections: A Series From Greece

2017 ◽  
Vol 16 (4) ◽  
pp. 255-259 ◽  
Author(s):  
Maria Demetriou ◽  
Nikolaos Papanas ◽  
Periklis Panagopoulos ◽  
Maria Panopoulou ◽  
Efstratios Maltezos
Keyword(s):  
Antibiotic Resistance ◽  
Soft Tissue ◽  
Diabetic Foot ◽  
Soft Tissues ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Soft Tissue Infections ◽  
Diabetic Foot Infections ◽  
Initial Choice ◽  
Gram Positive Cocci

Diabetic foot infections are a common and serious problem for all health systems worldwide. The aim of this study was to examine the resistance to antibiotics of microorganisms isolated from infected soft tissues of diabetic foot ulcers, using tissue cultures. We included 113 consecutive patients (70 men, 43 women) with a mean age of 66.4 ± 11.2 years and a mean diabetes duration of 14.4 ± 7.6 years presenting with diabetic foot soft tissue infections. Generally, no high antibiotic resistance was observed. Piperacillin-tazobactam exhibited the lowest resistance in Pseudomonas, as well as in the other Gram-negative pathogens. In methicillin-resistant Staphylococcus aureus isolates, there was no resistance to anti-Staphylococcus agents. Of note, clindamycin, erythromycin, and amoxycillin/clavulanic acid exhibited high resistance in Gram-positive cocci. These results suggest that antibiotic resistance in infected diabetic foot ulcers in our area is not high and they are anticipated to prove potentially useful in the initial choice of antibiotic regimen.

Short Courses of Antibiotics Are Safe in Necrotizing Soft Tissue Infections

2021 ◽  
pp. 000313482110517
Author(s):  
Maria G. Valadez ◽  
Neil Patel ◽  
Vince Chong ◽  
Brant A. Putnam ◽  
Ashkan Moazzez ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Debridement ◽  
Morbidity And Mortality ◽  
Source Control ◽  
High Morbidity ◽  
Soft Tissue Infections ◽  
Short Course ◽  
Significant Difference ◽  
Necrotizing Soft Tissue Infections ◽  
Antibiotic Courses

Introduction Necrotizing soft tissue infections (NSTIs) carry high morbidity and mortality. While early aggressive surgical debridement is well-accepted treatment for NSTIs, the optimum duration of adjunct antibiotic therapy is unclear. An increasing focus on safety and evidence-based antimicrobial stewardship suggests a value in addressing this knowledge gap. Objective To determine whether shorter antibiotic courses have similar outcomes compared to longer courses in patients with NSTI following adequate source control. Population 142 consecutive patients with surgically managed NSTI were identified on retrospective chart review between December 2014 and December 2018 at two academic medical centers. Results Patients were predominately male (74%) with a median age of 52 and similar baseline characteristics. The median number of debridements to definitive source control was 2 (IQR 1-3) with the short course group undergoing a greater number of debridements control 2.57 ± 1.8 vs 1.9 ± 1.2, ( P = .01). Of 142 patients, 34.5% received a short course and the remaining 65.5% received a longer course of antibiotics. There was no significant difference in the incidence of bacteremia or wound culture positivity between groups. There was also no significant difference in in-hospital mortality, 8% vs 6, ( P = .74), incidence of C. difficile infection, median length of stay, or 30-day readmission. Conclusion Provided adequate surgical debridement, similar outcomes in morbidity and mortality suggest antibiotic courses of 7 days or less are equally safe compared to longer courses.

scholarly journals Skin and Soft Tissue Infections: Bacteriological Profile and Antibiotic Resistance Pattern of Isolates

2013 ◽  
Vol 1 (3) ◽  
pp. 18-21
Author(s):  
P Sah ◽  
R Khanal ◽  
S Upadhaya
Keyword(s):  
Antibiotic Resistance ◽  
Soft Tissue ◽  
Resistance Pattern ◽  
Soft Tissue Infections ◽  
Medical Sciences ◽  
Coagulase Negative Staphylococci ◽  
Gram Negative ◽  
E Coli ◽  
Pseudomonas Spp ◽  
Microbiological Techniques

INTRODUCTION: Emergence and spread of antibiotic resistance in organisms causing skin and soft tissue infections (SSTIs) is posing a great therapeutic challenge. This study aimed to determine bacteriology of SSTIs and study antibiotic resistance among the isolates. MATERIAL AND METHODS: A retrospective analysis of 149 consecutive pus specimens received at microbiology laboratory of Universal College of Medical Sciences & Teaching Hospital, Bhairahawa over a period of 8 months from July 2012 to February 2013 was done. The bacterial isolates were identified by standard microbiological techniques and antibiotic susceptibility testing was done by Modified Kirby-Bauer method. RESULTS: Growth was seen in 92 (62%) specimens out of which 88 specimens yielded single isolate and 4 specimens yielded 2 isolates. Hence a total of 96 isolates were isolated. The commonest isolates were Staphylococcus aureus (n=39) followed by E. coli (n=11), Pseudomonas spp (n=11), Coagulase negative staphylococci (n=9), Klebsiella spp (n=6), Proteus spp (n=5), Streptococcus spp (n=4), Acinetobacter spp (n=1), and unidentified gram negative bacilli (n=10). Among gram positive cocci susceptibility to Amikacin was highest followed by vancomycin and gentamycin. Among gram negative bacilli aminoglycosides and ciprofloxacin susceptibility was high, however all E. coli isolates were ciprofloxacin resistant. Majority of isolates were resistant to amoxicillin, ceftriaxone and cotrimoxazole. CONCLUSION: In conclusion this study reports the commonest organism in SSTIs is S. aureus followed by E.coli and Pseudomonas spp. Continued monitoring of susceptibility pattern need to be carried out to detect the true burden of antibiotic resistance in organisms and prevent their further emergence by judicious use of drugs. DOI: http://dx.doi.org/10.3126/jucms.v1i3.8759 Journal of Universal College of Medical Sciences Vol.1(3) 2013: 18-21

scholarly journals Prospective Randomized Trial of Empiric Therapy with Trimethoprim-Sulfamethoxazole or Doxycycline for Outpatient Skin and Soft Tissue Infections in an Area of High Prevalence of Methicillin-Resistant Staphylococcus aureus

2007 ◽  
Vol 51 (7) ◽  
pp. 2628-2630 ◽  
Author(s):  
Mary Jo Cenizal ◽  
Daniel Skiest ◽  
Samuel Luber ◽  
Roger Bedimo ◽  
Pat Davis ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Soft Tissue ◽  
Failure Rate ◽  
Empirical Therapy ◽  
Soft Tissue Infections ◽  
Clinical Failure ◽  
Open Label ◽  
Methicillin Resistant ◽  
Significant Difference ◽  
High Prevalence

ABSTRACT To evaluate empirical therapy with trimethoprim-sulfamethoxazole or doxycycline for outpatient skin and soft tissue infections in an area of high prevalence of methicillin-resistant Staphylococcus aureus, a randomized, prospective, open-label investigation was performed. The overall clinical failure rate was 9%, with all failures occurring in the trimethoprim-sulfamethoxazole group. However, there was no significant difference between the clinical failure rate of empirical trimethoprim-sulfamethoxazole therapy and that of doxycycline therapy.

scholarly journals Cold Atmospheric Plasma Promotes Killing of Staphylococcus aureus by Macrophages

mSphere ◽  
2021 ◽  
Author(s):  
Constance Duchesne ◽  
Nadira Frescaline ◽  
Océane Blaise ◽  
Jean-Jacques Lataillade ◽  
Sébastien Banzet ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Soft Tissue ◽  
Atmospheric Plasma ◽  
Soft Tissue Infections ◽  
Content Type ◽  
Cold Atmospheric Plasma ◽  
Resistant Strains

Staphylococcus aureus is the most frequent cause of skin and soft tissue infections. Treatment failures are increasingly common due to antibiotic resistance and the emergence of resistant strains.

scholarly journals Comparison of Upper Limb Disability in Overhead Women Athletes of Handball, Volleyball, Softball, and Swimming

2021 ◽  
pp. 103-110
Author(s):  
Elmira Arabi ◽  
◽  
Gholam Hossein Nazemzadegan ◽  
Keyword(s):  
Women Athletes ◽  
Upper Limb ◽  
Study Groups ◽  
High Rate ◽  
Joint Disease ◽  
Overhead Athletes ◽  
Study Results ◽  
Significant Difference ◽  
The Difference ◽  
Post Hoc

Purpose: The shoulder joint is one of the most commonly injured joints in sports and may lead to disability, especially in the upper extremities of overhead players (handball, volleyball, softball, and swimming). Methods: This research is a causal-comparative study. After the approval of the Ethics Committee of the Medical University of Tehran, this study was conducted on 120 overhead athletes (Mean±SD height: 1.69±0.07 m, Mean±SD weight: 63.54±7.79 kg, Mean±SD age: 21.96±2.94 years, Mean±SD body mass index: 22.11±2.32 kg/m2). The inclusion criteria were elite female players in overhead sports with at least three years of experience in one of these sports (handball, volleyball, softball, and swimming). Samples with a history of surgery or cervical nerve problems, fractures in the shoulder area, and inflammatory joint disease were excluded from the study. The demographic information was obtained through a researcher-made questionnaire, and the Disabilities of the Arm, Shoulder and Hand (DASH) Questionnaire was used to measure the degree of upper limb disability in daily activities. Results: In comparison between the study groups, a significant difference was observed between the dependent variable (DASH) and the research groups (F=6.067, df=3, P=0.002, Eta=0.342). Using the Bonferroni post hoc tests, the difference between volleyball and softball (P=0.44), volleyball and swimming (P=0.009), and handball and swimming players (P=0.022) were reported. In the next step, BMI characteristics, weekly training hours, and the number of training sessions per week were entered into the data analysis process as covariate variables (F=8.099, df=0.3, P=0.000, Eta=0.432). The Bonferroni post hoc test indicates the difference between volleyball and swimming athletes (P=0.001) and handball and swimming (P=0.002). Conclusion: The present study results indicate a high rate of upper limb disability in elite women athletes. The present study results showed no difference between volleyball and handball due to the nature of these two disciplines and handball, softball, and swimming.

Significance of antibiotic resistance for the treatment of soft tissue infections

2002 ◽  
Vol 59 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Christian Ruef
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Resistance ◽  
Soft Tissue ◽  
Soft Tissue Infections ◽  
Gram Negative

Infektionen der Weichteile sind häufig. Das klinische Spektrum der Weichteilinfektionen umfasst Infektionen der Haut, der Subkutis sowie der darunter liegenden Weichteile, insbesondere der Faszie und der Muskulatur. Die Pathogenese der Weichteilinfektionen ist vielfältig. Auslöser ist in der Regel das Eindringen von pathogenen Mikroorganismen in die Haut, bzw. in die Weichteile im Rahmen einer Verletzung. Die wichtigsten Erreger, die zu Haut- und Weichteilinfektionen führen, sind Staphylokokken, insbesondere Staphylococcus aureus und Streptokokken, insbesondere Gruppe A-Streptokokken. Bei Patienten mit Immunsuppression oder bei Vorliegen besonderer Umstände könnnen auch Gram-negative Erreger zu Haut- und Weichteilinfektionen führen. Angesichts des Keimspektrums der meisten Weichteilinfektionen sind Betalaktam-Antibiotika mit ausreichender Aktivität gegen Staphylokokken die Medikamente erster Wahl. Da ein hoher Anteil der Staphylococcus aureus Penicillinase bilden, sind penicillinasefeste Betalaktame, insbesondere penicillinasefeste Penicilline vorzuziehen. Im Laufe der vergangenen 40 Jahre stellten wir zuerst das Auftreten der Penicillin-Resistenz bei Staphylokokken fest, anschließend dann das Auftreten und die Zunahme der Methicillin-Resistenz. Mittlerweile stellen Methicillin-resistente Staphylococcus aureus (MRSA) weltweit ein großes Problem dar, wobei die geographischen Unterschiede noch recht ausgeprägt sind. Ist mit einer hohen Wahrscheinlichkeit von MRSA zu rechnen, sollten Weichteilinfektionen, die klinisch das Potential zu einem schweren Verlauf haben, primär mit einem Glykopeptid (Vancomycin bzw. Teicoplanin) behandelt werden. Neue Medikamente wie zum Beispiel die Oxazolidinone (z.B. Linezolid) sowie Quinupristin/Dalfopristin stellen für die Zukunft interessante Alternativen zu den Glykopeptiden bei der Therapie von Weichteilinfektionen dar.

scholarly journals The effect of early broad-spectrum versus delayed narrow-spectrum antibiotic therapy on the primary cure rate of acute infection after osteosynthesis

2019 ◽  
Vol 46 (6) ◽  
pp. 1341-1350
Author(s):  
Pien Hellebrekers ◽  
Michiel H. J. Verhofstad ◽  
Luke P. H. Leenen ◽  
Hilal Varol ◽  
Esther M. M. van Lieshout ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Soft Tissue ◽  
Antibiotic Therapy ◽  
Acute Infection ◽  
Secondary Outcome ◽  
Soft Tissue Coverage ◽  
Success Rates ◽  
Trauma Centres ◽  
Significant Difference ◽  
Primary Success

Abstract Purpose Infection near metal implants is a problem that presents challenging treatment dilemmas for physicians. The aim of this study was to analyse the efficacy of two treatment protocols for acute fracture-related infections. Methods Seventy-one patients in two level-1 trauma centres in the Netherlands were retrospectively included in this study. These trauma centres had different standardised protocols for acute infection after osteosynthesis: 39 patients were selected from protocol A and 32 from protocol B. Both protocols involve immediate surgical debridement and soft tissue coverage, but differ in antibiotic approach: (A) immediate empirical combination antibiotic therapy with rifampicin, or (B) postponed (1–5 days) targeted antibiotic therapy. The primary outcome of these protocols was success, defined as a fracture healing in the absence of infection. The secondary outcome was antibiotic resistance patterns. Logistic regression was conducted on patients and treatment-related factors in association with primary success. Results Primary success was achieved in 72% of protocol A patients, in 47% of those in protocol B (P = 0.033), and with prolongation of treatment success was achieved in 90% and 78% of patients, respectively. Protocol A exhibited a better primary success rate (adjusted OR 3.45, CI 1.13–10.52) when adjusted for age and soft tissue injury. There was no significant difference in antibiotic resistance between the two protocols. Conclusion Both protocols yielded high overall success rates. Immediate empirical antibiotics can be used safely without additional bacterial resistance and may contribute to increased success rates.

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