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Distinguishing Cellulitis from Its Noninfectious Mimics
Cellulitis is a common clinical diagnosis in the outpatient and inpatient setting; studies have demonstrated a surprisingly high misdiagnosis rate: nearly one-third of cases are other conditions (ie, pseudocellulitis). This high rate of misdiagnosis is thought to contribute to nearly $515 million in avoidable health care spending in the United States each year; leading to the delayed or missed diagnosis of pseudocellulitis and to delays in appropriate treatment. There is a broad differential diagnosis for pseudocellulitis, which includes inflammatory and noninflammatory conditions of the skin. Accurate diagnosis of the spe...
Source: Infectious Diseases Clinics of North America - December 7, 2020 Category: Infectious Diseases Authors: Briana M. Garcia, Carla Cruz-Diaz, Ritesh Agnihothri, Kanade Shinkai Source Type: research

Staphylococcal Skin and Soft Tissue Infections
Staphylococcus aureus is the most common bacteria causing purulent skin and soft tissue infections. Many disease-causing S aureus strains are methicillin resistant; thus, empiric therapy should be given to cover methicillin-resistant S aureus. Bacterial wound cultures are important for characterizing local susceptibility patterns. Definitive antibiotic therapy is warranted, although there are no compelling data demonstrating superiority of any one antibiotic over another. Antibiotic choice is predicated by the infection severity, local susceptibility patterns, and drug-related safety, tolerability, and cost. Response to th...
Source: Infectious Diseases Clinics of North America - December 7, 2020 Category: Infectious Diseases Authors: Timothy J. Hatlen, Loren G. Miller Source Type: research

Necrotizing Soft Tissue Infections
Necrotizing soft tissue infections occur after traumatic injuries, minor skin lesions, nonpenetrating injuries, natural childbirth, and in postsurgical and immunocompromised patients. Infections can be severe, rapidly progressive, and life threatening. Survivors often endure multiple surgeries and prolonged hospitalization and rehabilitation. Despite subtle nuances that may distinguish one entity from another, clinical approaches to diagnosis and treatment are highly similar. This review describes the clinical and laboratory features of necrotizing soft tissue infections and addresses recommended diagnostic and treatment m...
Source: Infectious Diseases Clinics of North America - December 7, 2020 Category: Infectious Diseases Authors: Dennis L. Stevens, Amy E. Bryant, Ellie JC. Goldstein Source Type: research

Skin and Soft Tissue Infections in Persons Who Inject Drugs
Persons who inject drugs are at high risk for skin and soft tissue infections. Infections range from simple abscesses and uncomplicated cellulitis to life-threatening and limb-threatening infections. These infections are predominantly caused by gram-positive organisms with Staphylococcus aureus, Streptococcus pyogenes, and other streptococcal species being most common. Although antimicrobial therapy has an important role in treatment of these infections, surgical incision, drainage, and debridement of devitalized tissue are primary. Strategies that decrease the frequency of injection drug use, needle sharing, use of contam...
Source: Infectious Diseases Clinics of North America - December 7, 2020 Category: Infectious Diseases Authors: Henry F. Chambers Source Type: research

Skin and Soft Tissue Infections in Patients with Diabetes Mellitus
Skin and soft tissue infections are common in diabetics. Diabetic foot infection usually results from disruption of the skin barrier, trauma, pressure, or ischemic wounds. These wounds may become secondarily infected or lead to development of adjacent soft tissue or deeper bone infection. Clinical assessment and diagnosis of these conditions using a multidisciplinary management approach, including careful attention to antibiotic selection, lead to the best outcomes in patient care. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - December 7, 2020 Category: Infectious Diseases Authors: Christopher Polk, Mindy M. Sampson, Danya Roshdy, Lisa E. Davidson Source Type: research

Gram-Negative Skin and Soft Tissue Infections
Skin and soft tissue infections (SSTIs) frequently are encountered in clinical practice, and gram-negative bacilli (GNB) constitute an underrated portion of their etiology. The rate of GNB-causing SSTIs is increasing, especially with the rise in antimicrobial resistance. Although the diagnosis of SSTIs mostly is clinical, rapid diagnostic modalities can shorten the time to initiating proper therapy and improving outcomes. Novel antibiotics are active against GNB SSTIs and can be of great value in the management. This review provides an overview of the role of GNB in SSTIs and summarizes their epidemiology, risk factors, ou...
Source: Infectious Diseases Clinics of North America - December 7, 2020 Category: Infectious Diseases Authors: Jean-Francois Jabbour, Souha S. Kanj Source Type: research

Skin and Soft Tissue Infections in Non –Human Immunodeficiency Virus Immunocompromised Hosts
Skin and soft tissue infections among the non –human immunodeficiency virus infected immunosuppressed population are a serious and growing concern. Many pathogens can cause cutaneous infections in these patients owing to the highly varied and profound immune deficits. Although patients can be infected by typical organisms, the diversity and a ntimicrobial-resistant nature of the organisms causing these infections result in significant morbidity and mortality. The diagnostic approach to these infections in immunocompromised hosts can differ dramatically depending on the potential causative organisms. An understanding of n...
Source: Infectious Diseases Clinics of North America - December 7, 2020 Category: Infectious Diseases Authors: Shivan Shah, Samuel Shelburne Source Type: research

Decolonization of Staphylococcus aureus
Staphylococcus aureus infections are associated with increased morbidity, mortality, hospital stay, and health care costs. S aureus colonization has been shown to increase risk for invasive and noninvasive infections. Decolonization of S aureus has been evaluated in multiple patient settings as a possible strategy to decrease the risk of S aureus transmission and infection. In this article, we review the recent literature on S aureus decolonization in surgical patients, patients with recurrent skin and soft tissue infections, critically ill patients, hospitalized non –critically ill patients, dialysis patients, and nursi...
Source: Infectious Diseases Clinics of North America - December 7, 2020 Category: Infectious Diseases Authors: Sima L. Sharara, Lisa L. Maragakis, Sara E. Cosgrove Source Type: research

The Role of Antibiotic Stewardship and Telemedicine in the Management of Multidrug-Resistant Infections
This article summarizes the literature describing how antimicrobial stewardship and telemedicine interventions affect antimicrobial resistance. Discussion includes why we need stewardship, how to collaborate with team members, and the evidence of stewardship ’s and telemedicine’s impact on resistance. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 30, 2020 Category: Infectious Diseases Authors: Thomas M. File, Robin L.P. Jump, Debra A. Goff Source Type: research

Emerging Issues in Antifungal Resistance
Invasive fungal diseases continue to cause substantial mortality in the enlarging immunocompromised population. It is fortunate that the field has moved past amphotericin B deoxycholate as the only available antifungal drug but despite new classes of antifungal agents both primary and secondary drug resistance in molds and yeasts abound. From the rise of multiple-drug –resistant Candida auris to the agrochemical selection of environmental azole-resistant Aspergillus fumigatus, it is and will be critical to understand antifungal drug resistance and both prevent and treat it with new strategies and agents. (Source: Infecti...
Source: Infectious Diseases Clinics of North America - October 30, 2020 Category: Infectious Diseases Authors: John R. Perfect, Mahmoud Ghannoum Source Type: research

Resistance in Vancomycin-Resistant Enterococci
Serious infections owing to vancomycin-resistant enterococci have historically proven to be difficult clinical cases, requiring combination therapy and management of treatment-related toxicity. Despite the introduction of new antibiotics with activity against vancomycin-resistant enterococci to the therapeutic armamentarium, significant challenges remain. An understanding of the factors driving the emergence of resistance in vancomycin-resistant enterococci, the dynamics of gastrointestinal colonization and microbiota-mediated colonization resistance, and the mechanisms of resistance to the currently available therapeutics...
Source: Infectious Diseases Clinics of North America - October 30, 2020 Category: Infectious Diseases Authors: William R. Miller, Barbara E. Murray, Louis B. Rice, Cesar A. Arias Source Type: research

Antibiotic-Resistant Infections and Treatment Challenges in the Immunocompromised Host
This article reviews antibiotic resistance and treatment of bacterial infections in the growing number of patients who are immunocompromised: solid organ transplant recipients, the neutropenic host, and persons with human immunodeficiency virus and AIDS. Specific mechanisms of resistance in both gram-negative and gram-positive bacteria, as well as newer treatment options are addressed elsewhere and are only briefly discussed in the context of the immunocompromised host. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 30, 2020 Category: Infectious Diseases Authors: Donald Dumford, Marion J. Skalweit Source Type: research

The Ongoing Threat of Antimicrobial Resistance
The relentless spread of antimicrobial resistance (AMR) remains as salient a threat today as it was in 2016, when we last served as editors for this issue of Infectious Disease Clinics of North America. Since then, AMR continues to undermine progress in health care, economic development, food production, and life expectancy. Numerous governmental and nongovernmental organizations have called for action to curtail the unnecessary use of antibiotics and to strengthen antibiotic stewardship efforts. (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 30, 2020 Category: Infectious Diseases Authors: Richard R. Watkins, Robert A. Bonomo Tags: Preface Source Type: research

The Ongoing Challenge of Antimicrobial Resistance
INFECTIOUS DISEASE CLINICS OF NORTH AMERICA (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 30, 2020 Category: Infectious Diseases Authors: Richard R. Watkins, Robert A. Bonomo Source Type: research

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Elsevier (Source: Infectious Diseases Clinics of North America)
Source: Infectious Diseases Clinics of North America - October 30, 2020 Category: Infectious Diseases Source Type: research