Staphylococcus aureus-Associated Skin and Soft Tissue Infections: Anatomical Localization, Epidemiology, Therapy and Potential Prophylaxis

Abstract

Skin and soft tissue infections (SSTIs) are among the most common infections worldwide. They range in severity from minor, self-limiting, superficial infections to life-threatening diseases requiring all the resources of modern medicine. Community (CA) and healthcare (HA) acquired SSTIs are most commonly caused by Staphylococcus aureus . They have variable presentations ranging from impetigo and folliculitis to surgical site infections (SSIs). Superficial SSTIs may lead to even more invasive infections such as bacteraemia and osteomyelitis. Here we describe the anatomical localization of the different SSTI associated with S. aureus, the virulence factors known to play a role in these infections, and their current epidemiology. Current prevention and treatment strategies are also discussed. Global epidemiological data show increasing incidence and severity of SSTIs in association with methicillin-resistant S. aureus strains (MRSA). CA-SSTIs are usually less morbid compared to other invasive infections caused by S. aureus, but they have become the most prevalent, requiring a great number of medical interventions, extensive antibiotic use, and therefore a high cost burden. Recurrence of SSTIs is common after initial successful treatment, and decolonization strategies have not been effective in reducing recurrence. Furthermore, decolonization approaches may be contributing to the selection and maintenance of multi-drug resistant strains. Clinical studies from the early 1900s and novel autovaccination approaches suggest an alternative strategy with potential effectiveness: using vaccines to control S. aureus cutaneous infections.

Antibiotic Resistance Trends in Methicillin-Resistant Staphylococcus aureus Isolated in Kuwait Hospitals: 2011-2015

“…The observation that all MRSA isolates were susceptible to linezolid is similar to reports from other countries that MRSA isolates were susceptible to linezolid [20,22,25] . In addition, the MIC distribution of the glycopeptide antibiotics showed that the majority ( ∼ 97%) of the isolates were susceptible to vancomycin and teicoplanin (MIC: ≤ 2 μg/ml), confirming that vancomycin and teicoplanin remain viable options for treating MRSA infections in Kuwait.…”

Molecular Features of Virulence and Resistance Mechanisms in Nosocomial and Community-Acquired Staphylococcus aureus

“…and general (innate or acquired deficiencies of the immune system such as complement system deficiencies, granulocytopenia, agranulocytosis, AIDS, diabetes, immunosuppressive treatments, etc.). It is able to cause a plethora of community (CA) and health care (HA) infections, ranging from superficial skin infections to severe, and potentially fatal, invasive diseases [3][4][5] due to its ability to produce a spectrum of virulence factors and resistance to multiple antibiotics, frequently encoded by mobile genetic elements (MGEs) [6], which have eased the persistence of S. aureus in hospital environment [7]. S. aureus is causing skin and soft tissue infections (SSTIs), endovascular infections, pneumonia, septic arthritis, endocarditis, osteomyelitis, foreign-body infections, and sepsis [8].…”

Staphylococcus aureus Esx Factors Control Human Dendritic Cell Functions Conditioning Th1/Th17 Response

“…Approximately one third of the entire human population worldwide is asymptomatically colonized by S. aureus , which mainly inhabits epithelial surfaces (Missiakas and Schneewind, 2016). However, under certain circumstances, this bacterium can eventually become a life-threatening pathogen causing infections in skin and soft tissues, sepsis, endocarditis, osteomyelitis, pneumonia, and toxic shock syndrome (David and Daum, 2010; Olaniyi et al, 2016). S. aureus is responsible for infections both in the healthcare setting and in the community and, also due to its impressive capacity to develop antibiotic resistance, constitutes a major burden on human society (Monaco et al, 2016).…”