rifampin and Soft-Tissue-Infections

To determine the frequency and antibiotic susceptibility pattern of CA-MRSA in patients with uncomplicated skin and soft tissue infections reporting to the dermatology outpatient of a tertiary health care hospital.. A descriptive study.. Dermatology outpatient of a tertiary care hospital in Punjab province of Pakistan, from September 2020 to August 2021.. Patients of all age groups and both genders reporting during the study period with community-associated uncomplicated bacterial skin and soft tissue infections were enrolled in the study. Samples were collected from skin lesions and cultured on blood agar and MacConkey agar plates. Antimicrobial susceptibility testing using the modified Kirby Baur disc diffusion technique was performed.. A total of 157 patients were included in the study. Impetigo was most common infection (n=80, 51%), followed by Furunculosis (n=47, 29.9%). The frequency of MRSA isolates was 54.1% (n=85). MRSA was significantly more frequently isolated from patients with furunculous, carbuncle and cutaneous abscesses as compared to impetigo. All MRSA isolates were sensitive to linezolid, teicoplanin, and vancomycin. 97.6%, 84.7%, and 72.9% of MRSA isolates were sensitive to rifampicin, minocycline, and fusidic acid respectively. 89.4% of MRSA were sensitive to amikacin and clindamycin. 63.5% were sensitive to doxycycline and 58.8% were sensitive to co-trimoxazole. Only 20% of MRSA were sensitive to ciprofloxacin.. The antibiotics active against CA-MRSA including rifampicin, minocycline, amikacin, and clindamycin may be used empirically in patients with furunculosis, cutaneous abscess, and carbuncles. Linezolid, teicoplanin, and vancomycin should be reserved for severe infections.. Uncomplicated skin and soft tissue infections, Community-associated Methicillin-resistant staphylococcus aureus (CA-MRSA), Antibiotic susceptibility pattern.

Topics: Agar; Amikacin; Animals; Anti-Bacterial Agents; Clindamycin; Community-Acquired Infections; Female; Furunculosis; Humans; Impetigo; Linezolid; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Minocycline; Rifampin; Soft Tissue Infections; Staphylococcal Infections; Staphylococcal Skin Infections; Teicoplanin; Vancomycin

Biofilm has recently been highlighted as a complicating feature of necrotizing soft tissue infections (NSTI) caused by Streptococcus pyogenes (i.e., group A Streptococcus [GAS]) contributing to a persistence of bacteria in tissue despite prolonged antibiotic therapy. Here, we assessed the standard treatment of benzylpenicillin and clindamycin with or without rifampin in a tissue-like setting. Antibiotic efficacy was evaluated by CFU determination in a human organotypic skin model infected for 24 or 48 h with GAS strains isolated from NSTI patients. Antibiotic effect was also evaluated by microcalorimetric metabolic assessment in

Topics: Anti-Bacterial Agents; Humans; Rifampin; Soft Tissue Infections; Streptococcal Infections; Streptococcus pyogenes

This study aimed to describe the first two microbiologically confirmed cases of cutaneous and soft tissue Mycobacterium marinum infection in Bulgaria. The isolation of the Nontuberculous Mycobacteria (NTM) strains and their species identification was performed at NRL TB, NCIPD using specific media and cultivation conditions, and PCR based Line Probe Assay (LPA) from the positive cultures. The two patients had closely related jobs to fishes and water reservoirs and both of them had a similar clinical manifestation of M. mari-num infection known as "swimming pool" or "fish tank" granuloma. The prolonged specific treatment with at least two-drug combina-tion of rifampicin plus ethambutol and some complications were a big challenge for clinicians as well as the patients.

Topics: Adult; Antitubercular Agents; Bulgaria; Carpal Tunnel Syndrome; Culture Techniques; Delayed Diagnosis; DNA, Bacterial; Ethambutol; Female; Humans; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Occupational Diseases; Rifampin; Soft Tissue Infections

The objective of this study was to determine the prevalence of

Topics: Actinomycetales Infections; Animals; Anti-Bacterial Agents; Azithromycin; Clarithromycin; Drug Resistance, Multiple, Bacterial; Equidae; Erythromycin; Feces; Horses; Kentucky; Microbial Sensitivity Tests; Musculoskeletal Diseases; Prevalence; Respiratory System; Rhodococcus equi; Rifampin; Soft Tissue Infections

Complicated skin and soft tissue infections constitute a heterogeneous group of severe disorders, with surgical site infections being the most common hospital-acquired ones. The aim of our study was to investigate the synergistic and bactericidal activities of antimicrobial combinations of fosfomycin with rifampicin and tigecycline against Enterococcus faecalis, Enterococcus faecium and methicillin-resistant Staphylococcus aureus (MRSA) clinical isolates, and also to evaluate their in vivo effects in a mouse wound infection model. In in vitro studies, the combinations of fosfomycin with rifampicin and tigecycline were both synergistic. These synergies were confirmed in in vivo studies: the drug combinations showed the highest antimicrobial effects compared to monotherapy. In conclusion, the efficacy of fosfomycin combinations, also confirmed in our in vivo model, may suggest new directions in the treatment of infected skin and a possible alternative way to control bacterial skin infection.

Topics: Animals; Anti-Bacterial Agents; Enterococcus faecalis; Enterococcus faecium; Fosfomycin; Gram-Positive Cocci; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Mice; Mice, Inbred BALB C; Microbial Sensitivity Tests; Minocycline; Rifampin; Skin Diseases, Bacterial; Soft Tissue Infections; Surgical Wound Infection; Tigecycline

Daptomycin is a bactericidal antibiotic approved for the treatment of skin and soft tissue infections and right-side endocarditis. However, there is a lack of published data outlining its usefulness in vascular graft infections (VGI). The aim of this study was to describe the clinical experience of daptomycin use in the treatment of VGI caused by Gram-positive bacteria.. This was a retrospective cohort study of patients diagnosed with VGI receiving daptomycin at a tertiary care hospital during the period January 2010 to December 2012.. Of a total 1066 consecutive patients who had undergone vascular grafts (VG), 25 were diagnosed with VGI. Fifteen of these patients (11 prosthetic VG, three autologous VG, one both types) received daptomycin (median dose 6.7mg/kg/day, range 4.1-7.1mg/kg/day; median age 69 years, range 45-83 years; 80% male). The infected bypass was removed in 13 cases. The most common reason for selecting daptomycin was kidney failure (53%). The Gram-positive organisms isolated were coagulase-negative Staphylococcus (n=10), Staphylococcus aureus (n=3) (two methicillin-resistant S. aureus), Enterococcus faecium (n=2), and Enterococcus faecalis (n=1). The mean follow-up was 69 months (interquartile range 48-72 months). Ten patients (66.7%) achieved complete healing of the VGI. A recurrence of the infection was observed in 100% of patients in whom the bypass was not removed. Among patients who did not achieve complete healing, one needed a supracondylar amputation and one died as a consequence of infection. Five patients received treatment with rifampicin in addition to daptomycin and they were all cured.. The use of daptomycin and surgery for Gram-positive VGI was effective and well tolerated, and this may be a good alternative for the treatment of VGI in patients with peripheral arterial disease in whom renal insufficiency is common.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Daptomycin; Endocarditis; Enterococcus faecalis; Enterococcus faecium; Female; Follow-Up Studies; Gram-Positive Bacterial Infections; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Middle Aged; Recurrence; Retrospective Studies; Rifampin; Skin Diseases, Infectious; Soft Tissue Infections; Staphylococcus aureus; Treatment Outcome; Vascular Grafting; Wound Healing

There are limited data on the epidemiology, diagnosis and optimal management of nontuberculous mycobacterial (NTM) disease in children.. Retrospective cohort study of NTM cases over a 10-year-period at a tertiary referral hospital in Australia.. A total of 140 children with NTM disease, including 107 with lymphadenitis and 25 with skin and soft tissue infections (SSTIs), were identified. The estimated incidence of NTM disease was 0.6-1.6 cases / 100,000 children / year; no increasing trend was observed over the study period. Temporal analyses revealed a seasonal incidence cycle around 12 months, with peaks in late winter/spring and troughs in autumn. Mycobacterium-avium-complex accounted for most cases (77.8%), followed by Mycobacterium ulcerans (14.4%) and Mycobacterium marinum (3.3%). Polymerase chain reaction testing had higher sensitivity than culture and microscopy for acid-fast bacilli (92.0%, 67.2% and 35.7%, respectively). The majority of lymphadenitis cases underwent surgical excision (97.2%); multiple recurrences in this group were less common in cases treated with clarithromycin and rifampicin compared with clarithromycin alone or no anti-mycobacterial drugs (0% versus 7.1%; OR:0.73). SSTI recurrences were also less common in cases treated with two anti-mycobacterial drugs compared with one or none (10.5% versus 33.3%; OR:0.23).. There was seasonal variation in the incidence of NTM disease, analogous to recently published observations in tuberculosis, which have been linked to seasonal variation in vitamin D. Our finding that anti-mycobacterial combination therapy was associated with a reduced risk of recurrences in patients with NTM lymphadenitis or SSTI requires further confirmation in prospective trials.

Topics: Adolescent; Anti-Bacterial Agents; Child; Child, Preschool; Clarithromycin; Cohort Studies; DNA, Bacterial; Female; Humans; Infant; Infant, Newborn; Lymphadenitis; Male; Mycobacterium avium Complex; Mycobacterium Infections, Nontuberculous; Mycobacterium marinum; Mycobacterium ulcerans; Retrospective Studies; Rifampin; Skin Diseases; Soft Tissue Infections; Tertiary Care Centers

We report a first human case of Porphyromonas pogonae causing soft tissue infection in a patient with open fracture. Strong β-hemolytic, aerotolerant, and non-pigmented gram-negative coccobacilli which matched Porphyromonas pogonae by PCR for 16S rRNA genes were identified from the pus specimen. The clinical course of the patient improved with repeated surgical drainage and tigecycline administration.

Topics: Adult; Anti-Bacterial Agents; Bacteroidaceae Infections; Ciprofloxacin; DNA, Bacterial; Fractures, Bone; Humans; Male; Minocycline; Porphyromonas; Rifampin; RNA, Ribosomal, 16S; Sequence Analysis, DNA; Soft Tissue Infections; Suppuration; Tigecycline

This paper presents a rare case of facial soft tissue infection caused by the bacterial strain of Rothia mucilaginosa. Odontogenic background of infection and initial clinical presentation suggested the presence of typical bacterial flora and uncomplicated course of treatment. However, despite surgical intervention and broad-spectrum antibiotic therapy, the expected improvement of a clinical status was not achieved. Only detailed bacteriological examination allowed to establish a bacterial pathogen and start a targeted antibiotic therapy. The unusual clinical course was monitored by imaging CT examination and further surgical interventions. A significant improvement was obtained in the third week of hospitalization and further antibiotic therapy was continued by means of outpatient treatment. Rothia mucilaginosa infection together with dental intervention is a rare case, since most of the reports in the literature concern the patients with decreased immunity. In such patients, the most common areas of infection were: the peritoneum, lung tissue and meningeal spaces of the brain and the presence of a foreign body. 

Topics: Abscess; Adult; Anti-Bacterial Agents; Cheek; Drug Administration Schedule; Female; Gram-Positive Bacterial Infections; Humans; Micrococcus; Rifampin; Soft Tissue Infections; Tooth Extraction; Toothache; Trismus; Young Adult

Methicillin-resistant Staphylococcus aureus (MRSA) has a high prevalence in Emergency Departments (EDs). The objective of this study was to determine the ability of emergency physicians to predict MRSA infection in purulent wounds. A prospective observational study was conducted in an urban, tertiary academic center in ED patients presenting with purulent wounds and abscesses that received wound culture. Physicians completed a questionnaire with patient demographic data and their own suspicion for MRSA infection in eligible patients. For emergency physician ability to predict positive culture for MRSA, sensitivities, specificities, and positive and negative likelihood ratios (LRs) were calculated. Risk factors were assessed for statistical significance using a chi-squared test with p < 0.05. There were 176 patients enrolled, and 19 were eliminated for incomplete data. Physician suspicion of MRSA had a sensitivity of 80% (95% confidence interval [CI] 71%-87%) and a specificity of 23.6% (95% CI 14%-37%) for the presence of MRSA on wound culture with a positive LR of 1.0 (95% CI 0.9-1.3) and a negative LR of 0.8 (95% CI 0.5-1.3). Prevalence was 64%. Only intravenous drug use was significantly associated with MRSA. Emergency physician's suspicion of MRSA infection is a poor predictor of MRSA infection.

Topics: Anti-Infective Agents; Emergency Service, Hospital; Female; Humans; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Prospective Studies; Rifampin; Sensitivity and Specificity; Soft Tissue Infections; Staphylococcal Infections; Staphylococcal Skin Infections; Trimethoprim, Sulfamethoxazole Drug Combination

Community-associated methicillin-resistant Staphylococcus aureus infections are increasingly being documented worldwide. In Israel, however, CA-MRSA infections have not yet been reported, so awareness among physicians may be low.. To alert physicians to the possibility of CA-MRSA infection, which necessitates a distinct therapeutic approach.. We present three children with soft tissue infections caused by CA-MRSA who were treated in our medical center from January to March 2009.. In all three cases CA-MRSA was identified as the causative pathogen after surgical or spontaneous drainage. On susceptibility testing, the organisms were resistant to beta-lactam antibiotics but susceptible to clindamycin, rifampicin and trimethoprim-sulfamethoxazole.. Physicians should maintain an index of suspicion for CA-MRSA infections. The antibiotic-resistance profile of S. aureus should be watched carefully, and in particular, cultures should be obtained whenever soft tissue infections fail to respond to conventional treatment.

Topics: Adolescent; Anti-Bacterial Agents; Child, Preschool; Clindamycin; Community-Acquired Infections; Drug Combinations; Female; Humans; Israel; Male; Methicillin-Resistant Staphylococcus aureus; Rifampin; Soft Tissue Infections; Staphylococcal Infections; Sulfadoxine; Trimethoprim

The knowledge about efficacy of linezolid alone or in combination with rifampin in device infections is limited. We test their in vitro and in vivo efficacy in a rat model of foreign-body infection by methicillin-susceptible S. aureus.. In vitro studies for logarithmic and stationary bacteria were performed. In vivo efficacy (decrease in bacterial counts in tissue cage fluid) was evaluated at: (i) after 7-day therapy (groups: linezolid, cloxacillin, rifampin, linezolid-rifampin and cloxacillin-rifampin); and (ii) after 10-day therapy (groups: rifampin and linezolid-rifampin).. After 7-day therapy all groups were significantly better than controls; linezolid (Delta log cfu/ml: -0.59, no resistant strains) and cloxacillin (-0.85) were the least effective therapy; linezolid was significantly less active (P<0.05) than rifampin (-1.22, resistance 90%), cloxacillin-rifampin (-1.3) and linezolid-rifampin (-1.14). After 10-day therapy linezolid-rifampin was the most effective treatment (Delta log -1.44, no resistance, P<0.05); in contrast, rifampin resulted ineffective (Delta log 0.1) due to the growth of resistant strains (100%).. Linezolid alone showed moderate efficacy, whereas its combination with rifampin prevented the emergence of rifampin resistance. The efficacy of linezolid-rifampin combination was initially similar to that of rifampin alone, but in contrast to rifampin, it increased over time revealing the impact of protection against rifampin resistance and the benefits of rifampin activity.

Topics: Acetamides; Animals; Anti-Bacterial Agents; Colony Count, Microbial; Drug Resistance, Bacterial; Drug Therapy, Combination; Foreign Bodies; Linezolid; Male; Microbial Sensitivity Tests; Microbial Viability; Oxazolidinones; Rats; Rifampin; Soft Tissue Infections; Staphylococcal Infections; Treatment Outcome

Infection due to Mycobacterium ulcerans or Buruli ulcer usually occurs on the limbs (70%) or trunk (20%). Involvement of the head and neck region is less frequent but can lead to serious sequels. The purpose of this report is to describe 8 patients including 7 children who were treated for Buruli ulcers on the head in the dermatology department of the University Hospital Center in Abidjan, Cote d'Ivoire. Eye lesions and visual impairment were the most frequent sequels.

Topics: Adolescent; Anti-Bacterial Agents; Anticoagulants; Buruli Ulcer; Child; Child, Preschool; Cote d'Ivoire; Enoxaparin; Eye Infections, Bacterial; Face; Female; Humans; Male; Ofloxacin; Rifampin; Severity of Illness Index; Soft Tissue Infections; Young Adult

Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTI) have become increasingly common. This study's objectives were to describe the clinical spectrum of MRSA in a community health center and to determine whether the use of specific antimicrobials correlated with increased probability of clinical resolution of SSTI. A retrospective chart review of 399 sequential cases of culture-confirmed S. aureus SSTI, including 227 cases of MRSA SSTI, among outpatients at Fenway Community Health (Boston, MA) from 1998 to 2005 was done. The proportion of S. aureus SSTI due to MRSA increased significantly from 1998 to 2005 (P<0.0001). Resistance to clindamycin was common (48.2% of isolates). At the beginning of the study period, most patients with MRSA SSTI empirically treated with antibiotics received a beta-lactam, whereas by 2005, 76% received trimethoprim-sulfamethoxazole (TMP-SMX) (P<0.0001). Initially, few MRSA isolates were sensitive to the empirical antibiotic, but 77% were susceptible by 2005 (P<0.0001). A significantly higher percentage of patients with MRSA isolates had clinical resolution on the empirical antibiotic by 2005 (P=0.037). Use of an empirical antibiotic to which the clinical isolate was sensitive was associated with increased odds of clinical resolution on empirical therapy (odds ratio=5.91), controlling for incision and drainage and HIV status. MRSA now accounts for the majority of SSTI due to S. aureus at Fenway, and improved rates of clinical resolution on empirical antibiotic therapy have paralleled increasing use of empirical TMP-SMX for these infections. TMP-SMX appears to be an appropriate empirical antibiotic for suspected MRSA SSTI, especially where clindamycin resistance is common.

Topics: Adult; Ambulatory Care Facilities; Anti-Bacterial Agents; Boston; Female; HIV Infections; Humans; Male; Methicillin Resistance; Middle Aged; Soft Tissue Infections; Staphylococcal Infections; Staphylococcal Skin Infections; Staphylococcus aureus; Treatment Outcome

The authors report three cases of skin ulcer, called Buruli's ulcer. This is a tropical disease, caused by Mycobacterium ulcerans. The diagnosis is often belated, because the infection is rare in Europe. Diagnosis is based on the clinical aspects, and can be confirmed by a biopsy and a molecular study. A culture is needed to test antibiotics. Treatment is always surgical, including a wide excision of all lesions, and specific oral antibiotics for 6 months.

Topics: Anti-Bacterial Agents; Child; Clarithromycin; Cote d'Ivoire; France; Humans; Leg; Male; Mycobacterium Infections, Nontuberculous; Mycobacterium ulcerans; Rifampin; Soft Tissue Infections

Topics: Adult; Amenorrhea; Antibiotics, Antitubercular; Diagnostic Techniques, Endocrine; Female; Humans; Neck; Norethindrone; Progesterone Congeners; Rifampin; Soft Tissue Infections; Treatment Outcome; Tuberculoma

Topics: Abscess; Anti-Bacterial Agents; Antibiotics, Antitubercular; Child, Preschool; Clarithromycin; Combined Modality Therapy; Drainage; Drug Therapy, Combination; Face; Female; Humans; Microbial Sensitivity Tests; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Rifampin; Soft Tissue Infections; Tuberculin Test

Two case reports of deep hand infections with Mycobacterium avium-intracellulare are presented. Both occurred in elderly men. Aggressive surgical débridement combined with antitubercular chemotherapy resulted in an excellent outcome in both cases. Atypical mycobacterial infections should be considered in the differential diagnosis of any patient with prolonged and progressive tenosynovitis. A complete history, including temporally remote inoculation injuries or immunocompromised host status, should be elicited. Acid-fast staining and mycobacterial cultures, including reduced-temperature cultures, must be included in the diagnostic evaluation. Therapy should include immediate and aggressive surgical débridement, as well as appropriate chemotherapy.

Topics: Aged; Antibiotics, Antitubercular; Debridement; Drug Therapy, Combination; Hand; Humans; Male; Mycobacterium avium-intracellulare Infection; Rifampin; Soft Tissue Infections; Tenosynovitis