Wednesday, September 26, 2007
Severe skin and soft tissue infections and associated critical illness.
Curr Infect Dis Rep. 2007 Sep
Vinh DC, Embil JM.
Infection Prevention and Control Unit, Health Sciences Centre, MS 673-820 Sherbrook Street, Winnipeg, Manitoba, R3A 1R9, Canada. firstname.lastname@example.org.
Skin and soft tissue infections (SSTIs) span a broad spectrum of clinical entities from limited cellulitis to rapidly progressive necrotizing fasciitis, which may be associated with septic shock or a toxic shock-like syndrome. These infections may be the primary instigators of critical illness requiring hospitalization and management in the intensive care unit. Alternatively, these infections may arise from metastatic spread of microorganisms from a distant focus. Regardless of the source, SSTIs may lead to critical illness.
The complex interplay of environment, host, and pathogen are important to consider when evaluating SSTIs and planning therapy. This second of a two-part review focuses on severe SSTIs due to Clostridium spp, microorganisms associated with water sources, and polymicrobial/mixed infections.
The key to a successful outcome is early identification of risk factors for specific pathogens and early initiation of empiric antimicrobial therapy. For some SSTIs, surgical intervention for diagnosis and/or therapy is also required.
PMID: 17880853 [PubMed - in process]
Wednesday, September 12, 2007
The role of biofilms in otolaryngologic infections: update 2007.
Post JC, Hiller NL, Nistico L, Stoodley P, Ehrlich GD.
aCenter for Genomic Sciences, Allegheny Singer Research Institute, Pittsburgh, Pennsylvania, USA bPediatric Otolaryngology, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA cDepartment of Microbiology and Immunology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
PURPOSE OF REVIEW: Biofilms have been shown to play a role in otitis media, sinusitis, cholesteatoma, tonsillitis, adenoiditis, and device infections. This article is written to review recent advances in the field.
RECENT FINDINGS: The role of biofilms in the persistence of chronic, mucosal-based ENT-related infections was first recognized in otitis media. Definitive proof was lacking until the demonstration of bacterial biofilms on the middle-ear mucosa of children, not only with chronic otitis media with effusion, but also with recurrent otitis media. Strains of Pseudomonas aeruginosa isolated from cholesteatoma are avid biofilm formers. Biofilms have been reported in the adenoids of children with chronic rhinosinusitis, helping to explain the clinical observation that adenoidectomy can be beneficial to children with chronic otitis or chronic rhinosinusiti. Additional studies have confirmed the presence of biofilms in chronic tonsillitis. Biofilms have also been shown to be involved in infected cochlear implants and tracheotomy tubes.
SUMMARY: The recognition that chronic otolaryngologic bacterial infections are biofilm related has been the impetus for the development of new technologies for the study of biofilms and their prevention and treatment. Understanding that chronic bacterial infections are biofilm related is fundamental to developing rationale strategies for treatment and prevention.
Lippincott, Williams, Wilkins