tetracycline and Soft-Tissue-Infections

Clostridium septicum is a highly pathogenic microbe that causes gas gangrene in humans, and is the principal cause of spontaneous gas gangrene in patients with gastrointestinal maladies, including adenocarcinoma of the colon. Despite modern approaches to manage C. septicum infection, morbidity and mortality remain high (>60%). At present, no objective in-vivo data exist supporting the current antibiotic treatment recommendations for C. septicum infection. Utilizing an established murine model of clostridial myonecrosis, this study investigated the efficacy of standard antibiotics for anaerobic Gram-positive soft tissue infections (penicillin, clindamycin, tetracycline and vancomycin) in treating C. septicum gas gangrene. Following intramuscular challenge with 1 × 10

Topics: Animals; Anti-Bacterial Agents; Clindamycin; Clostridium Infections; Clostridium septicum; Drug Administration Schedule; Female; Humans; Injections, Intramuscular; Injections, Intraperitoneal; Mice; Microbial Sensitivity Tests; Muscle, Skeletal; Penicillins; Soft Tissue Infections; Survival Analysis; Tetracycline; Vancomycin

Swine production work is a risk factor for nasal carriage of livestock-associated (LA-) Staphylococcus aureus and also for skin and soft tissue infection (SSTI). However, whether LA-S. aureus nasal carriage is associated with increased risk of SSTI remains unclear. We aimed to examine S. aureus nasal carriage and recent (≤3 months prior to enrollment) SSTI symptoms among industrial hog operation (IHO) workers and their household contacts. IHO workers and their household contacts provided a nasal swab and responded to a questionnaire assessing self-reported personal and occupational exposures and recent SSTI symptoms. Nasal swabs were analyzed for S. aureus, including methicillin-resistant S. aureus (MRSA), multidrug-resistant-S. aureus (MDRSA), absence of scn (livestock association), and spa type. S. aureus with at least one indicator of LA was observed among 19% of 103 IHO workers and 6% of 80 household members. Prevalence of recent SSTI was 6% among IHO workers and 11% among 54 minor household members (0/26 adult household members reported SSTI). Among IHO workers, nasal carriers of MDRSA and scn-negative S. aureus were 8.8 (95% CI: 1.8, 43.9) and 5.1 (95% CI: 1.2, 22.2) times as likely to report recent SSTI as non-carriers, respectively. In one household, both an IHO worker and child reported recent SSTI and carried the same S. aureus spa type (t4976) intranasally. Prevalence of scn-negative S. aureus (PR: 5.0, 95% CI: 1.2, 21.4) was elevated among IHO workers who reported never versus always wearing a face mask at work. Although few SSTI were reported, this study of IHO workers and their household contacts is the first to characterize a relation between nasal carriage of antibiotic-resistant LA-S. aureus and SSTI. The direction and temporality of this relation and IHO workers' use of face masks to prevent nasal carriage of these bacteria warrant further investigation.

Topics: Adult; Animals; Family Characteristics; Female; Humans; Industry; Livestock; Male; Methicillin-Resistant Staphylococcus aureus; Nose; Occupational Exposure; Prevalence; Risk Factors; Skin; Soft Tissue Infections; Staphylococcal Infections; Swine; Tetracycline

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

Topics: Anti-Bacterial Agents; Bacterial Infections; Child; Humans; Infant; Oxytetracycline; Peritonitis; Soft Tissue Infections; Tetracycline

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Child; Dermatologic Agents; Humans; Infant; Infections; Novobiocin; Protein Synthesis Inhibitors; Soft Tissue Infections; Tetracycline

Topics: Anti-Bacterial Agents; Bacterial Infections; Humans; Peritonitis; Soft Tissue Infections; Tetracycline

Topics: Anti-Bacterial Agents; Infections; Phosphates; Protein Synthesis Inhibitors; Soft Tissue Infections; Tetracycline

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Infections; Nystatin; Phosphates; Protein Synthesis Inhibitors; Soft Tissue Infections; Tetracycline

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Dermatologic Agents; Infections; Novobiocin; Phosphates; Protein Synthesis Inhibitors; Soft Tissue Infections; Tetracycline

Topics: Anti-Bacterial Agents; Infections; Protein Synthesis Inhibitors; Soft Tissue Infections; Tetracycline