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Can e coli penetrate the skin

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Recognition of the potential for...

Skin and soft tissue infections SSTIs are common, and complicated SSTIs cSSTIs are the more extreme end of this Can e coli penetrate the skin spectrum, encompassing a range of clinical presentations such as deep-seated infection, a requirement for surgical intervention, the presence of systemic signs of sepsis, the presence of complicating co-morbidities, accompanying neutropenia, accompanying ischaemia, tissue necrosis, burns and bites.

Staphylococcus aureus is the commonest cause of SSTI across all continents, although its epidemiology in terms of causative strains and antibiotic susceptibility can no longer be predicted with accuracy.

The epidemiology of community-acquired and healthcare-acquired strains is constantly shifting and this presents challenges in the choice of empirical antibiotic therapy. Toxin production, particularly with Panton—Valentine leucocidin, may complicate the presentation still further. Polymicrobial infection with Gram-positive and Gram-negative organisms and anaerobes may occur in infections approximating the rectum or genital tract and in diabetic foot infections and burns.

Successful management of cSSTI involves prompt recognition, timely surgical debridement or drainage, resuscitation if required and appropriate antibiotic therapy.

Penetration of E. coli and...

The mainstays of treatment are the penicillins, cephalosporins, clindamycin and co-trimoxazole. A range of new agents for the treatment of methicillin-resistant S.

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These include linezolid, daptomycin and tigecycline. The latter and fluoroquinolones with enhanced anti-Gram-positive activity such as moxifloxacin are better suited for polymicrobial infection.

Skin and soft tissue infections SSTIs are ubiquitous and the most common of infections, suffered by everyone at some point to a lesser or greater degree and encountered by all doctors. SSTIs reflect inflammatory microbial invasion of the epidermis, dermis and subcutaneous tissues.

Indeed, the classical signs of inflammation were described in SSTI by Celsus in the first century as calor, rubor, tumor and dolor heat, redness, swelling and pain. To these four signs is often added a fifth—fluor discharge.

The skin is the largest organ of the body and, with the underlying soft tissue, which includes the fat layers, fascia and muscle, represents the majority of the tissue in the body. It acts as a tough, flexible, structural barrier to invasion. The skin is colonized with an indigenous microbial flora, which typically consists of a variety of species of staphylococci, corynebacteria, propionibacteria and yeasts, in numbers that may vary from a few hundred to many thousands per square centimetre in the moister areas such as the groin and axillae.

Breaks in the skin, such as leg ulcers, burns and surgical or traumatic wounds, allow colonization with a broader range of bacteria. Can e coli penetrate the skin of ulcers does not usually result in inflammation, but occasionally infection of the surrounding tissues may result from lateral spread of the colonizing organisms.

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