A skin and skin structure infection (SSSI), also referred to as skin and soft tissue infection (SSTI) or acute bacterial skin and skin structure infection (ABSSSI), is an infection of skin and associated soft tissues (such as loose connective tissue and mucous membranes). The pathogen involved is usually a bacterial species. Such infections often requires treatment by antibiotics.
Until 2008, two types were recognized, complicated skin and skin structure infection (cSSSI) and uncomplicated skin and skin structure infection (uSSSI).[1] "Uncomplicated" SSSIs included simple abscesses, impetiginous lesions, furuncles, and cellulitis. "Complicated" SSSIs included infections either involving deeper soft tissue or requiring significant surgical intervention, such as infected ulcers, burns, and major abscesses or a significant underlying disease state that complicates the response to treatment. Superficial infections or abscesses in an anatomical site, such as the rectal area, where the risk of anaerobic or gram-negative pathogen involvement is higher, should be considered complicated infections.[2] The two categories had different regulatory approval requirements. The uncomplicated category (uSSSI) is normally only caused by Staphylococcus aureus and Streptococcus pyogenes, whereas the complicated category (cSSSI) might also be caused by a number of other pathogens. In cSSSI, the pathogen is known in only about 40% of cases.
Because cSSSIs are usually serious infections, physicians do not have the time for a culture to identify the pathogen, so most cases are treated empirically, by choosing an antibiotic agent based on symptoms and seeing if it works. For less severe infections, microbiologic evaluation via tissue culture has been demonstrated to have high utility in guiding management decisions.[3] To achieve efficacy, physicians use broad-spectrum antibiotics. This practice contributes in part to the growing incidence of antibiotic resistance, a trend exacerbated by the widespread use of antibiotics in medicine in general. The increased prevalence of antibiotic resistance is most evident in methicillin-resistant Staphylococcus aureus (MRSA). This species is commonly involved in cSSSIs, worsening their prognosis, and limiting the treatments available to physicians. Drug development in infectious disease seeks to produce new agents that can treat MRSA.[citation needed]
Since 2008, the U.S. Food and Drug Administration has changed the terminology to "acute bacterial skin and skin structure infections" (ABSSSI).[4] The Infectious Diseases Society of America (IDSA) has retained the term "skin and soft tissue infection".[5]
See also
List of cutaneous conditions
Linezolid
Tedizolid
References
^Rosen, T (2005). "Update on treating uncomplicated skin and skin structure infections". Journal of Drugs in Dermatology. 4 (6 Suppl): s9–14. PMID 16300224.
^"Guidance for Industry - Acute Bacterial Skin and Skin Structure Infections: Developing Drugs for Treatment" (PDF). Food and Drug Administration. October 2013. Retrieved 2014-11-23.
^Xia, Fan Di; Song, Philip; Joyce, Cara; Mostaghimi, Arash (2017). "The Utility of Microbiological Studies in Diagnosis and Management of Suspected Dermatological Infection". JAMA Dermatology. doi:10.1001/jamadermatol.2017.3057.
^"Guidance for Industry Acute Bacterial Skin and Skin Structure Infections: Developing Drugs for Treatment" (PDF). Aug 2010.
^Stevens, D. L.; Bisno, A. L.; Chambers, H. F.; Dellinger, E. P.; Goldstein, E. J. C.; Gorbach, S. L.; Hirschmann, J. V.; Kaplan, S. L.; Montoya, J. G.; Wade, J. C. (18 June 2014). "Practice Guidelines for the Diagnosis and Management of Skin and Soft Tissue Infections: 2014 Update by the Infectious Diseases Society of America". Clinical Infectious Diseases. 59 (2): e10–e52. doi:10.1093/cid/ciu296. PMID 24947530.
External links
Cellulitis Skin Infection Treatment
One hour audio on SSSI especially uSSSI
Link to journal article
UpToDate Contents
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Abstract Context: Anthrax is a rare disease caused by Bacillus anthracis. Antrax is zoonotic disease and is often encountered in persons engaged in animal husbandry. Cutaneous anthrax is approximately 95% of anthrax in humans. Palbebral involvement is rare. Objective: In this study, we aimed to eval
The effect of an acidic cleanser versus soap on the skin pH and micro-flora of adult patients: A non-randomised two group crossover study in an intensive care unit.
Duncan CN, Riley TV, Carson KC, Budgeon CA, Siffleet J.SourceICU Research Nurse, Intensive Care Unit, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Western Australia, Australia; School of Pathology & Laboratory Medicine, The University of Western Australia, Division of Microbiology & Infectious Diseases, PathWest Laboratory Medicine, Queen Elizabeth II Medical Centre, Hospital Avenue, Nedlands, Western Australia, Australia. Electronic address: Christine.Duncan@health.wa.gov.au.
Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses.Intensive Crit Care Nurs.2013 Oct;29(5):291-6. doi: 10.1016/j.iccn.2013.03.005. Epub 2013 May 10.
OBJECTIVES: To test the effects of two different cleansing regimens on skin surface pH and micro-flora, in adult patients in the intensive care unit (ICU).RESEARCH METHODOLOGY: Forty-three patients were recruited from a 23-bed tertiary medical/surgical ICU. The nineteen patients in Group One were wa
Japanese Journal of Infectious Diseases 66(5), 416-420, 2013
… CA-MRSA infections with the USA300 clone are very rare in Japan. … In this study, we describe 4 cases of CA-MRSA infections, particularly the USA300 clone. … Both men were members of a combat sports gym where other members also had skininfections. … Only 5 cases of USA300 infections were reported in Japan from 2007 to 2009, and 4 cases were detected at Tokyo Medical University Hospital from 2010 to 2011. …
Outbreak of Multiresistant OXA-24- and OXA-51-Producing Acinetobacter baumannii in an Internal Medicine Ward
Tena Daniel,Martínez Nora Mariela,Oteo Jesús,Sáez David,Vindel Ana,Azañedo María Luisa,Sánchez Lorenzo,Espinosa Alfredo,Cobos Juan,Sánchez Rosario,Otero Ignacio,Bisquert Julia
Japanese Journal of Infectious Diseases 66(4), 323-326, 2013
… Over a 6-week period, 5 MRAB isolates were recovered from 5 patients, including 1 with fatal meningitis, 3 with skin and soft tissue infections, and 1 with respiratory colonization. …