Specific PCR, bacterial culture, serology and pharyngeal sampling to enhance the aetiological diagnosis of cellulitis.

We examined the utility of molecular techniques, skin and throat cultures, as well as serology in providing evidence of either Staphylococcus aureus or Group A streptococcus (GAS) presence in patients with cellulitis. Samples were collected from patients with a clinical diagnosis of cellulitis who were recruited into a prospective placebo controlled clinical trial (C4C study, EudraCT 2013-001218-14). Specific PCR, paired serology and culture for both organisms were carried out on a variety of samples where appropriate. Despite utilising a range of diagnostic methods, a bacteriological diagnosis was only achieved in 43% of patients with a clinical diagnosis of cellulitis. 17% of patients tested positive for GAS by any method but only 4% were positive by PCR; whilst S. aureus was detected in 25% of samples. Bacterial diagnosis in cases of cellulitis remains challenging. This is likely due to a very low bacterial burden with toxin production resulting in inflammation mediating skin damage. Further consideration for the need long courses of antimicrobial therapy for cellulitis therefore appears merited. PMID: 26487664 [PubMed - as supplied by publisher]
Source: Journal of Medical Microbiology - Category: Microbiology Authors: Tags: J Med Microbiol Source Type: research