Community-acquired methicillin-resistant staphylococcus aureus skin infection: an emerging clinical problem

Cohen, Philip R.; Kurzrock, Razelle

doi:10.1016/j.jaad.2003.06.005

Cited by 73 publications

(78 citation statements)

References 15 publications

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“…Furthermore, in recent years MRSA strains have emerged in several countries as significant community-acquired pathogens [14, 15] and are predominantly associated with skin and soft tissue infections in previously healthy children with no recognizable risk factors and in adults [16,17,18]. Our study further supports this observation, showing that in addition to the already reported presentations of community-acquired MRSA skin infection (abscess and cellulitis) [18, 19], erysipelas represents another clinical manifestation for this pathogen. Furthermore, it suggests that empirical antibiotic treatment of staphylococcal bullous erysipelas with β-lactams may not be sufficient.…”

Section: Discussionmentioning

confidence: 99%

Bullous Erysipelas: Clinical Presentation, Staphylococcal Involvement and Methicillin Resistance

Krasagakis

Samonis²,

Maniatakis³

et al. 2006

Dermatology

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Background: Erysipelas is a bacterial infection of the dermis and hypodermis, mostly of streptococcal origin. Bullous erysipelas represents a severe form of the disease. Objective: To evaluate the clinical and microbiological characteristics and treatment of bullous erysipelas. Methods: Patients with a diagnosis of bullous erysipelas who were treated at the Department of Dermatology, University Hospital of Heraklion, Crete, Greece, between the years 1996 and 2001 were retrospectively studied. Results: Fourteen patients (11 women, 3 men) with bullous erysipelas were evaluated. The lesions were located on the legs and face in 9 and 4 patients, respectively. The median duration of disease before hospital admission was 4 days. Eight patients had fever at presentation. Local trauma and various lesions were common causes for pathogen entry. The initial empirical antibiotic treatment included intravenous β-lactams and was modified according to the sensitivities of the isolated strains. Staphylococcus aureus was isolated from 7 (50%), while S. warneri, Streptococcus pyogenes and Escherichia coli grew from the lesions of 3 other patients. Six out of 7 S. aureus strains were methicillin resistant (MRSA) but susceptible to several other non-β-lactam antibiotics such as quinolones, vancomycin, rifampicin and trimethoprim/sulfamethoxazole. Conclusion: Our findings suggest that S. aureus is frequently involved in and probably contributes in synergy with β-hemolytic streptococci to the complicated course of bullous erysipelas. The frequency of MRSA isolation suggests that β-lactam antibiotics may not be sufficient for the treatment of bullous erysipelas anymore, at least in areas with a high incidence of MRSA strains. The role of other classes of antibiotics providing adequate coverage for MRSA has to be evaluated in prospective clinical trials.

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Section: Discussionmentioning

confidence: 99%

Bullous Erysipelas: Clinical Presentation, Staphylococcal Involvement and Methicillin Resistance

Krasagakis

Samonis²,

Maniatakis³

et al. 2006

Dermatology

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“…5 Outros estudos apontam para prevalência de 53% de S. aureus meticilina-resistente. 6 As manifestações clínicas podem variar desde lesões cutâneas sem gravidade até choque séptico. O acometimento cutâneo é o mais prevalente, podendo alcançar 94% das manifestações clínicas decorrentes da infecção por essa bactéria.…”

Section: Discussionunclassified

“…5,7,8 Os abscessos e as furunculoses são as lesões mais relatadas. 2,3,5,6,8 Também são descritos celulite, pápulas ou nódulos eritematosos, placas com crostas (impetigo) ou ainda FIGURA 1: Lesões furunculoides em coxa FIGURA 2: Linha 1. amostra da paciente deste caso; Linha 2. amostra pertencente a uma variante do clone OSPC, usada para comparação; Linha 3. amostra do clone BEC (Brazilian epidemic clone), típica do MRSA hospitalar a combinação desses quadros clínicos. 6 A resistência à meticilina ocorre pela produção da PBP2a, proteína ligadora à penicilina que diminui a atividade da maioria das penicilinas.…”

Section: Discussionunclassified

CA-MRSA em furunculose: relato de caso do sul do Brasil

Razera

Stefani

Bonamigo

et al. 2009

An. Bras. Dermatol.

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Resumo: Staphylococcus aureus resistente à meticilina (MRSA), outrora isolado especificamente em ambientes hospitalares, vem sendo identificado como causador de infecções cutâneas em pacientes da comunidade. Neste artigo, é relatado um caso do sul do Brasil com furunculose por CA-MRSA. O microrganismo isolado foi submetido a exames de PCR para o gene mecA e para o gene que codifica a leucocidina de Panton-Valentine. Esses exames permitiram a identificação genotípica do CA-MRSA. Palavras-chave: Furunculose; Resistência a meticilina; Staphylococcus aureus Abstract: Methicillin-resistant Staphylococcus aureus (MRSA), particularly isolated at hospital setting, has been identified in cutaneous infections of community patients. This paper reports a case of furunculosis from the southern Brazil. Dermatologists must be attentive to this emergent etiological diagnosis. The isolated microorganism was subjected to PCR for gene mecA and to PCR for the gene that encodes the leukocidin of Panton-Valentine. These exams enabled genotypic identification of CA-MRSA.

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“…Such infections persist until treated and thus must be differentiated from acute angioedema [2,29]. It is important to consider infection as well as angioedema when confronted with lower lip swelling in the emergency department [41,42]. Few cases of methicillin-resistant Staphylococcus aureus-related facial or lip infections mimicking angioedema are present in the literature [42].…”

Section: Infectionsmentioning

confidence: 99%

Pseudoangioedema

Akarsu¹,

Canturk²

2017

A Comprehensive Review of Urticaria and Angioedema

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Angioedema is a rapid, localized and temporary subcutaneous edema, which targets the lips, eyelids, gastrointestinal and respiratory mucosa resulting in abdominal pain, asthma and even serious life-threatening conditions like airway obstruction. There are several other disorders such as allergic contact dermatitis, drug rash with eosinophilia and systemic symptoms (DRESS), superior vena cava syndrome (SVCS), orofacial granulomatosis and so on, which manifest with subcutaneous swelling and masquerade as angioedema and are known as 'pseudoangioedema' in the literature. Knowledge of pseudoangioedema for healthcare professionals is crucial to avoid potentially serious results of misdiagnosis such as further investigations, unnecessary applications and delayed diagnosis. We aim to discuss differential diagnosis of angioedema and help physicians recognize the typical features of angioedema and its differential diagnosis in this chapter.

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Community-acquired methicillin-resistant staphylococcus aureus skin infection: an emerging clinical problem

Cited by 73 publications

References 15 publications

Bullous Erysipelas: Clinical Presentation, Staphylococcal Involvement and Methicillin Resistance

Bullous Erysipelas: Clinical Presentation, Staphylococcal Involvement and Methicillin Resistance

CA-MRSA em furunculose: relato de caso do sul do Brasil

Pseudoangioedema

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