Cellulitis due to
            <i>Escherichia coli</i>
            in three immunocompromised subjects

Yoon, Tae Young; Jung, Seok Ki; Chang, Sung Man

doi:10.1046/j.1365-2133.1998.02519.x

Cited by 30 publications

(18 citation statements)

References 16 publications

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“…The most common causative agents are Staphylococcus aureus and aerobic streptococci (9,10,41,43). However, several reports associating the enterobacterium Escherichia coli with SSTI have been published: E. coli was found to be the causative agent of neonatal omphalitis (7), cellulitis localized to lower or upper limbs (4,6,49), necrotizing fasciitis (1,25,28), surgical site infections (44), infections after burn injuries (37), and others. A study monitoring SSTIs during a 7-year period and encompassing three continents (Europe, Latin America, and North America) showed E. coli to be an important causative agent, since it was the third-most prevalent isolated species, preceded solely by S. aureus and Pseudomonas aeruginosa.…”

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confidence: 99%

Virulence Potential of Escherichia coli Isolates from Skin and Soft Tissue Infections

et al. 2009

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Escherichia coli strains frequently are isolated from skin and soft tissue infections (SSTI); however, their virulence potential has not yet been extensively studied. In the present study, we characterized 102 E. coli SSTI strains isolated mostly from surgical and traumatic wounds, foot ulcers, and decubitus. The strains were obtained from the Institute of Microbiology and Immunology, University of Ljubljana, Slovenia. Phylogenetic backgrounds, virulence factors (VFs), and antibiotic resistance profiles were determined. Correlations between VFs and phylogenetic groups were established and analyzed with regard to patient factors. Further, the associations of the three most prevalent antibiotic resistance patterns with virulence potential were analyzed. Our results showed that the majority of the studied strains (65%) belonged to the B2 phylogenetic group. The most prevalent VF was ompT (80%), while toxin genes cnf1 and hlyA were found with prevalences of 32 and 30%, respectively. None of the investigated bacterial characteristics were significantly associated with patient gender, age, type of infection, or immunodeficiency. The most prevalent antibiotic resistance pattern was resistance to ampicillin (46%), followed by resistance to tetracycline (25%) and fluoroquinolones (21%). Strains resistant to ciprofloxacin exhibited a significantly reduced prevalence of cnf1 (P < 0.05) and usp (P < 0.01). Our study revealed that E. coli isolates from SSTIs exhibit a remarkable virulence potential that is comparable to that of E. coli isolates from urinary tract infections and bacteremia.Skin and soft tissue infections (SSTIs) are one of the most common infections in patients of all age groups. Infections mostly are self limited or can be treated with antibiotics. However, moderate or severe cases may require hospitalization and parenteral therapy (30). The most common causative agents are Staphylococcus aureus and aerobic streptococci (9, 10, 41, 43). However, several reports associating the enterobacterium Escherichia coli with SSTI have been published: E. coli was found to be the causative agent of neonatal omphalitis (7), cellulitis localized to lower or upper limbs (4, 6, 49), necrotizing fasciitis (1,25,28), surgical site infections (44), infections after burn injuries (37), and others. A study monitoring SSTIs during a 7-year period and encompassing three continents (Europe, Latin America, and North America) showed E. coli to be an important causative agent, since it was the third-most prevalent isolated species, preceded solely by S. aureus and Pseudomonas aeruginosa. The beta-hemolytic Streptococcus sp. group was only the 7th-ranked pathogen in North America and Europe and was 10th in Latin America in terms of prevalence (30). E. coli isolates from SSTI therefore merit detailed studies, especially taking into account the dramatic decline in antibiotic susceptibility of pathogenic E. coli strains in recent years. Despite the need for the characterization of E. coli strains from SSTI, to our knowledge only a single E...

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Virulence Potential of Escherichia coli Isolates from Skin and Soft Tissue Infections

et al. 2009

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“…We supposed that the skin infection was secondary to bloodstream infection from a digestive source (translocation). Very few cases of this have been described in the literature and the few reported cases all occurred in immunocompromised patients (Brzozowski & Ross, 1997;Kang et al, 2010;Sleiman et al, 2007;Yoon et al, 1998).…”

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Life-threatening Escherichia coli cellulitis in patients with haematological malignancies

Sunder

Haguenoer

Bouvet

et al. 2012

Journal of Medical Microbiology

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“…Staphylococcus aureus and Streptococcus pyogenes are responsible for the majority of cellulitis cases in patients without cirrhosis [1,2]. Gram-negative infections are considered in perianal cellulitis, immunocompromised patients [3,4] and patients with nephrotic syndrome [5]. There are several case studies [6][7][8][9][10] and one case series [11] of gram-negative cellulitis in patients with cirrhosis.…”

Section: Introductionmentioning

confidence: 99%

Cellulitis in Patients with Cirrhosis and Edema: An Under-Recognized Complication Currently More Common than Spontaneous Bacterial Peritonitis

Rongey¹,

Runyon²

2008

TOGASJ

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Abstract:Background: Cellulitis is often a recurring infection resulting in hospitalizations. In patients with cirrhosis, gram-negative bacilli may be causative. Methods:Retrospective chart review of patients admitted to a dedicated Liver Unit in a tertiary referral center. Risk factors, characteristics and antibiotic treatment of patients with cirrhosis and edema complicated by cellulitis were compared to similar patients without cellulitis. We compared the frequency of cellulitis to that of spontaneous bacterial peritonitis in the same cohort. Our study is the largest case series focusing on the factors which predispose patients with cirrhosis to cellulitis.Results: Of 145 consecutive patients who were admitted to this unit during 1 year's time, 19.3% were diagnosed with cellulitis compared to 4.1% diagnosed with spontaneous bacterial peritonitis. Cellulitis recurred in 21.4% of our patients. Significant risk factors for cellulitis included history of trauma or break in the skin barrier, homelessness, body mass index on admission and subjective degree of ascites and edema. Hospital stay was four days longer in patients with cellulitis, although this finding was not statistically significant. The duration of intravenous antibiotic treatment was 11.9 days. Conclusions:The incidence and recurrence rates of cellulitis in patients with cirrhosis and edema are very high and appear to be higher than those of spontaneous bacterial peritonitis in the current era. The diagnosis of cellulitis remains a clinical one as laboratory values and body temperature may not reveal the diagnosis and wound cultures are not usually helpful. Optimal antibiotic treatment warrants further delineation as continued intravenous antibiotic treatment may prolong hospitalization.

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Cellulitis due to Escherichia coli in three immunocompromised subjects

Cited by 30 publications

References 16 publications

Virulence Potential of Escherichia coli Isolates from Skin and Soft Tissue Infections

Virulence Potential of Escherichia coli Isolates from Skin and Soft Tissue Infections

Life-threatening Escherichia coli cellulitis in patients with haematological malignancies

Cellulitis in Patients with Cirrhosis and Edema: An Under-Recognized Complication Currently More Common than Spontaneous Bacterial Peritonitis

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