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      Incidence of bacterial skin infections in Libya: a retrospective population-based study

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      , , ,
      Iberoamerican Journal of Medicine
      Hospital San Pedro
      Bacteria, Skin, Infection, Libya

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          Abstract

          Abstract Introduction: The global burden of bacterial skin infection is substantial. We aimed to determine the common pathogens causes skin infections and their antimicrobial resistance pattern. Methods: A retrospective record review of data claimed from the microbiology department at Ber-Ustta Milad skin hospital between Jan 2009 to December 2018 was conducted. The consequence of interest was the antimicrobial sensitivity of bacterial isolates. Chi square was used for statistical analysis. Results: Out of 1,141 collected samples, a total of 455 isolates of different medically-significant bacteria were analyzed. The most common pathogen was S. aureus (97.14%), followed by E. coli (93.71%), and the least common was Shigella (0.57%). From the various inoculated samples, S. aureus and Proteus were highly resistant to penicillin (34.3%, 75% respectively) and ampicillin (28.6%, 62.5% respectively). E. coli was highly resistant to ampicillin (45.12%) and penicillin (35.96%), whereas the lowest resistant was against imipenem (3.05%). While, Pseudomonas was highly resistant to ampicillin and augmentin (62.5%), whereas the lowest resistance rate was marked to erythromycin, sulfamethoxazole and imipenem (25%). Ciprofloxacin, gentamicin and nalidixic acid were the only sensitive agents. Conclusions: There is a high burden of bacterial resistance to common antibiotics in our population samples. Recognition of the potential resistant strains of pathogen causing skin infection can help in guiding proper choice of antibiotic therapy.

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          Incidence, microbiology, and patient characteristics of skin and soft-tissue infections in a U.S. population: a retrospective population-based study

          Background Skin and soft tissue infections (SSTIs) are commonly occurring infections with wide-ranging clinical manifestations, from mild to life-threatening. There are few population-based studies of SSTIs in the period after the rapid increase in community-acquired methicillin-resistant Staphyloccus aureus (MRSA). Methods We used electronic databases to describe the incidence, microbiology, and patient characteristics of clinically-diagnosed skin and soft tissue infections (SSTIs) among members of a Northern California integrated health plan. We identified demographic risk factors associated with SSTIs and MRSA infection. Results During the three-year study period from 2009 to 2011, 376,262 individuals experienced 471,550 SSTI episodes, of which 23% were cultured. Among cultured episodes, 54% were pathogen-positive. Staphylococcus aureus (S. aureus) was isolated in 81% of pathogen-positive specimens, of which nearly half (46%) were MRSA. The rate of clinically-diagnosed SSTIs in this population was 496 per 10,000 person-years. After adjusting for age group, gender, race/ethnicity and diabetes, Asians and Hispanics were at reduced risk of SSTIs compared to whites, while diabetics were at substantially higher risk compared to non-diabetics. There were strong age group by race/ethnicity interactions, with African Americans aged 18 to <50 years being disproportionately at risk for SSTIs compared to persons in that age group belonging to other race/ethnicity groups. Compared to Whites, S. aureus isolates of African-Americans and Hispanics were more likely to be MRSA (Odds Ratio (OR): 1.79, Confidence Interval (CI): 1.67 to 1.92, and, OR: 1.24, CI: 1.18 to 1.31, respectively), while isolates from Asians were less likely to be MRSA (OR: 0.73, CI: 0.68 to 0.78). Conclusions SSTIs represent a significant burden to the health care system. The majority of culture-positive SSTIs were caused by S. aureus, and almost half of the S. aureus SSTIs were methicillin-resistant. The reasons for African-Americans having a higher likelihood, and Asians a lower likelihood, for their S. aureus isolates to be methicillin-resistant, should be further investigated.
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            Epidemiology and microbiology of skin and soft tissue infections.

            Skin and soft tissue infections (SSTIs) are a broad spectrum of diseases, including uncomplicated and complicated infections. Herein, we review the current epidemiology and microbiology of SSTIs.
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              The role of beta-hemolytic streptococci in causing diffuse, nonculturable cellulitis: a prospective investigation.

              Staphylococcus aureus and beta-hemolytic streptococci (BHS) are the 2 main types of bacteria causing soft-tissue infections. Historically, BHS were believed to be the primary cause of diffuse, nonculturable cellulitis. However, with the recent epidemic of community-associated methicillin-resistant S aureus (MRSA) causing culturable soft-tissue infections, it is currently unclear what role either of these bacteria has in cases where the cellulitis is diffuse and nonculturable. This uncertainty has led to broad-spectrum and haphazard use of antibiotics for this infection type, which has led to increased risk of adverse drug reactions, health care costs, and emergence of resistance in bacteria. To investigate this issue, we conducted a prospective investigation between December 2004 and June 2007, enrolling all adult patients admitted to the inpatient service at the Olive View-UCLA Medical Center, a county hospital of Los Angeles, with diffuse, nonculturable cellulitis. Acute and convalescent serologies for anti-streptolysin-O and anti-DNase-B antibodies were obtained. Patient data were analyzed for response to beta-lactam antibiotics. The primary outcome was the proportion of these cases caused by BHS, as diagnosed by serologies and/or blood cultures, and the secondary outcome was the response rate of patients to beta-lactam antibiotics. Of 248 patients enrolled, 69 were dropped from analysis because of loss to follow-up or exclusion criteria. Of the 179 remaining patients, 73% of nonculturable cellulitis cases were caused by BHS. Analysis of outcomes to beta-lactam antibiotic treatment revealed that patients diagnosed with BHS had a 97% (71/73) response, while those who did not have BHS had a 91% (21/23) response, with an overall response rate of 95.8% (116/121). Results of this large, prospective study show that diffuse, nonculturable cellulitis is still mainly caused by BHS, despite the MRSA epidemic, and that for this infection type, treatment with beta-lactam antibiotics is still effective. A cost-effective, evidence-based algorithm can be useful for the empiric management of uncomplicated soft-tissue infections based on the presence or absence of a culturable source.
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                Author and article information

                Journal
                ijm
                Iberoamerican Journal of Medicine
                Iberoam J Med
                Hospital San Pedro (Logroño, La Rioja, Spain )
                2695-5075
                2695-5075
                2021
                : 3
                : 1
                : 3-6
                Affiliations
                [1] Tripoli orgnameUniversity of Tripoli orgdiv1Faculty of Medical Technology orgdiv2Department of Anesthesia and Intensive Care Libia
                Article
                S2695-50752021000100002 S2695-5075(21)00300100002
                10.5281/zenodo.4252549
                f600e4b3-2c93-469e-b149-2edb2e7ec5e0

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 26 October 2020
                : 06 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 16, Pages: 4
                Product

                SciELO Spain

                Categories
                Original Article

                Libya,Bacteria,Skin,Infection
                Libya, Bacteria, Skin, Infection

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