Wednesday, January 30, 2013
Infections Succumbs to Blue Light
Infections Succumbs to Blue Light
January 2013
Blue light can selectively eradicate Pseudomonas aeruginosa infections of the skin and soft tissues, while preserving the outermost layer of skin, according to a proof-of-principle study led by Michael R. Hamblin of the Massachusetts General Hospital, and the Harvard Medical School in Boston. The research is published online ahead of print in the journal Antimicrobial Agents and Chemotherapy.
"Blue light is a potential non-toxic, non-antibiotic approach for treating skin and soft tissue infections, especially those caused by antibiotic resistant pathogens," says Hamblin.
In the study, animal models were infected with P. aeruginosa. All of the animals in the group treated with blue light survived, while in the control, 82 percent (9 out of 11) of the animals died.
Skin and soft tissue infections are the second most common bacterial infections encountered in clinical practice, and represent the most common infection presentation—more than 3 percent—in patients visiting emergency departments, says Hamblin. The prevalence of skin and soft tissue infections among hospitalized patients is 10 percent, with approximately 14.2 million ambulatory care visits every year and an annual associated medical cost of almost $24 billion (equivalent to $76 for every American), says Hamblin.
Treatment of skin and soft tissue infections has been significantly complicated by the explosion of antibiotic resistance, which may bring an end to what medical scientists refer to as the antibiotic era, says Hamblin. "Microbes replicate very rapidly, and a mutation that helps a microbe survive in the presence of an antibiotic drug will quickly predominate throughout the microbial population. Recently, a dangerous new enzyme, NDM-1, that makes some bacteria resistant to almost all antibiotics available has been found in the United States. Many physicians are concerned that several infections soon may be untreatable."
Besides harming public health, antibiotic resistance boosts health care costs. "Treating resistant skin and soft tissue infections often requires the use of more expensive, or more toxic drugs, and can result in longer hospital stays for infected patients," says Hamblin.
Reference: Dai T, Gupta A, et al. 2013. Blue light rescues mice from potentially fatal Pseudomonas aeruginosa burn infection: efficacy, safety, and mechanism of action. Antim. Agents Chemother. Published ahead of print Dec. 21, 2012 ,doi:10.1128/AAC.01652-12)
Labels: Antibiotic resistance, blue light, enzyme, Infection, NDM-1, Pseudomonas aeruginos, skin infections, soft tissue infections, treatment
# posted by Pat O'Connor @ 9:46 AM
Saturday, September 01, 2012
Antibiogram testing of pediatric skin infections in the era of methicillin-resistant Staphylococci aureus: an Egyptian University Hospital-based study.
Antibiogram testing of pediatric skin infections in the era of methicillin-resistant Staphylococci aureus: an Egyptian University Hospital-based study.
August 2012
Source
Departments of Dermatology and Venereology Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Abstract
Background Community-associated methicillin-resistant Staphylococci aureus (CA-MRSA) pediatric skin infections have been reported worldwide. However, little is known about pathogens' implications in Egyptian children, and beta-lactams are still the empiric antimicrobials prescribed. This warrants Egyptian studies on antibiogram testing of pediatric skin infections.
Objectives To determine antibiotic susceptibility patterns of bacterial isolates from Egyptian pediatric skin infections to find out if we need reconsideration of the empiric beta-lactam antimicrobial therapy.
Materials and methods Throughout an eight-month cross-sectional study, antibiogram testing was conducted on bacterial isolates from pediatric skin infections. Determination of inducible resistance to clindamycin using D-test was performed for isolates susceptible to clindamycin and resistant to erythromycin.
Results One-hundred and 21 children (mean age 6.9 years ± 3 SD) presented with pyogenic skin infections. Methicillin-sensitive Staphylococci aureus (MSSA) were isolated from 114 children, associated with group A Streptococci (GAS) in four of them, while GAS were the only isolates in three patients. A diagnosis of CA-MRSA was fulfilled in four children. Antibiotic susceptibilities differed between isolated organisms but with no statistically significant differences between susceptibility patterns of isolates from primary skin infections and those from secondary infection of skin diseases. Positive D-test was detected in five MSSA isolates.
Conclusions CA-MRSA skin infections are not common among Egyptian children and, therefore, beta-lactams are still effective empiric antimicrobial therapy for most infections. Antibiogram testing from suppurative skin lesions are, however, better to be recommended to guide individual therapy. Clindamycin should not be considered for susceptible isolates unless they are erythromycin susceptible or D-test negative.
Labels: Antibiogram, antibiotic susceptibility, CA-MRSA, clindamycin, group A Streptococci, methicillin-resistant Staphylococci aureus, skin infections, skin lesions
# posted by Pat O'Connor @ 9:08 AM
Sunday, March 23, 2008
The evaluation and treatment of complicated skin and skin structure infections
The evaluation and treatment of complicated skin and skin structure infections
April 2008
Exper Opinion on Parhmacotherapy
Paul B Cornia1,2 MD, Heather L Davidson1 MD & Benjamin A Lipsky1 MD
1University of Washington School of Medicine, Primary and Specialty Medicine Service, Veterans Affairs Puget Sound Health Care System and Department of Medicine, Seattle, WA 98108-1597, USA
2Assistant Professor of Medicine University of Washington, VA Puget Sound Health Care System (S-111), 1660 South Columbian Way, Seattle, WA 98108-1597, USA +1 206 764 2551; +1 206 764 2936; paul.cornia@med.va.gov
Background:
Skin and skin structure infections are frequently encountered in clinical practice. Fortunately, these infections usually produce only mild to moderate symptoms and signs. Some, however, are severe and may even be life-threatening.
Objective:
To review the approach to the evaluation and treatment of patients with complicated skin and skin structure infections and to discuss when to consider using either established antibiotics or recently licensed agents for treating these infections.
Methods:
In addition to a non-systematic literature review of complicated skin and skin structure infections and necrotizing fasciitis, we identified recent articles examining the microbiology and describing recently licensed antibiotics for treating these infections.
Results/conclusions:
Clinicians must learn to recognize the early symptoms and signs of severe skin and skin structure infections to ensure they select appropriate empiric antibiotic therapy and, when needed, obtain prompt surgical consultation. While the recent approvals of new agents for treating these infections are welcome, particularly in light of the continued emergence of antibiotic-resistant bacteria, traditional antibiotic regimens remain appropriate for most cases.
Expert Opinion
April 2008
Exper Opinion on Parhmacotherapy
Paul B Cornia1,2 MD, Heather L Davidson1 MD & Benjamin A Lipsky1 MD
1University of Washington School of Medicine, Primary and Specialty Medicine Service, Veterans Affairs Puget Sound Health Care System and Department of Medicine, Seattle, WA 98108-1597, USA
2Assistant Professor of Medicine University of Washington, VA Puget Sound Health Care System (S-111), 1660 South Columbian Way, Seattle, WA 98108-1597, USA +1 206 764 2551; +1 206 764 2936; paul.cornia@med.va.gov
Background:
Skin and skin structure infections are frequently encountered in clinical practice. Fortunately, these infections usually produce only mild to moderate symptoms and signs. Some, however, are severe and may even be life-threatening.
Objective:
To review the approach to the evaluation and treatment of patients with complicated skin and skin structure infections and to discuss when to consider using either established antibiotics or recently licensed agents for treating these infections.
Methods:
In addition to a non-systematic literature review of complicated skin and skin structure infections and necrotizing fasciitis, we identified recent articles examining the microbiology and describing recently licensed antibiotics for treating these infections.
Results/conclusions:
Clinicians must learn to recognize the early symptoms and signs of severe skin and skin structure infections to ensure they select appropriate empiric antibiotic therapy and, when needed, obtain prompt surgical consultation. While the recent approvals of new agents for treating these infections are welcome, particularly in light of the continued emergence of antibiotic-resistant bacteria, traditional antibiotic regimens remain appropriate for most cases.
Expert Opinion
Labels: antibiotic therapy, bacterial myonecrosis. skin structurw infections, necrotizing fasciitis, skin infections
# posted by Pat O'Connor @ 12:25 AM
Wednesday, September 26, 2007
Severe skin and soft tissue infections and associated critical illness.
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. jembil@hsc.mb.ca.
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]
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. jembil@hsc.mb.ca.
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]
Labels: necrotizing fasciitis, skin infections, soft tissue infections
# posted by Pat O'Connor @ 4:57 AM
