Deep Soft Tissue Infection Research Articles

Staphylococcus aureus carriage and HIV-1 disease: association with increased mucocutaneous infections as well as deep soft-tissue infections and sepsis

Cutaneous colonization by<i>Staphylococcus aureus</i>has been found to be significantly increased in patients infected with the human immunodeficiency virus (HIV-1). The incidence of<i>S aureu</i>s carriage was shown to stay relatively constant with disease progression, Walter Reed (WR) stage 1 through 6.¹ <i>Staphylococcus aureus</i>sepsis, deep soft-tissue infections, and pneumonia have all been frequently reported in patients with advancing HIV-1 disease, and<i>S aureus</i>infections, often undiagnosed premortem, were seen in greater than 50% of the patients from one autopsy study.²Trauma, intravenous catheters (peripheral and central lines), intravenous drug abuse, and lymphedema are considered to be risk factors. As part of a study on the natural history of cutaneous disease in HIV-1 disease, patients were followed up prospectively to determine if there was a correlation with infection by<i>S aureus</i>and the stage of disease. <h3>Patients and Methods.</h3> A total of 646 HIV-1—positive patients were

Staphylococcus aureus Carriage and HIV-1 Disease: Association With Increased Mucocutaneous Infections as well as Deep Soft-Tissue Infections and Sepsis

Staphylococcus aureus Carriage and HIV-1 Disease: Association With Increased Mucocutaneous Infections as well as Deep Soft-Tissue Infections and Sepsis

Deep soft tissue infections

In the year that has elapsed since the previous review of this subject, there is some evidence that the prevalence pattern of deep soft tissue infections may be changing. Perhaps not surprisingly, a prominent predisposing factor associated with the occurrence of deep soft tissue infections is the presence of some form of host immunoalteration. Thus, advanced age, administration of exogenous immunosuppressive medication for transplantation and inflammatory diseases, diabetes mellitus, and infection with the human immunodeficiency virus are increasingly common risk factors identified in reports of patients who develop deep soft tissue infections.

Deep soft-tissue infections

Deep soft-tissue infections

Aztreonam therapy for serious gram-negative infections in children.

Fifty-nine children were enrolled in an open trial of aztreonam, a monocyclic beta-lactam, therapy for serious gram-negative infections. Thirty-six infections were microbiologically evaluable and received five or more days of therapy. Patients' ages ranged from 3 days to 12 years, and diagnoses included pyelonephritis or cystitis (20), deep soft tissue or joint infection (seven), septicemia (four), pneumonia (three), peritonitis, and epiglottitis. Causative bacteria included Escherichia coli and other Enterobacteriaceae, Pseudomonas aeruginosa, and Haemophilus influenzae. The standard regimen was 30 mg/kg every six or eight hours intravenously. All isolates were aztreonam-susceptible and were eradicated during therapy. Two patients had microbiologic relapses: a patient with Salmonella choleraesuis meningitis who was initially treated for only ten days and a patient with E coli pyelonephritis. Clinical cure was achieved in 31 of 36 children. Pharmacokinetic studies performed in six children demonstrated no difference in serum concentrations or pharmacokinetic variables between day 1 and day 7 of therapy. Although several patients had transient eosinophilia (eight), elevated levels of aminotransferase (seven), or thrombocytosis (ten), no clinically significant adverse effects were noted. In this initial, uncontrolled study, aztreonam was effective and safe in the treatment of a variety of serious gram-negative infections in children.

Evaluation of ciprofloxacin in the treatment of Pseudomonas aeruginosa infections.

The efficacy and safety of ciprofloxacin in the treatment of Pseudomonas aeruginosa infections was evaluated in 72 patients suffering from upper urinary tract infection (19 patients), deep soft tissue infection (16), chronic osteomyelitis (12), abscess (7), chronic otitis media (6), otitis externa (3) and bronchopneumonia (9). Forty-eight patients received an oral dose of 500 mg or 750 mg b.i.d. and five patients an i.v. dose of 200 mg b.i.d., while 19 patients were given both oral and parenteral doses. The duration of therapy ranged from seven days to more than four months. The MICs of ciprofloxacin for the Pseudomonas aeruginosa strains isolated were in the range less than 0.06-2 mg/l; 36% of the strains were resistant to all other available antibiotics. At follow-up after a minimum of six months the clinical success rate was 75% and the infecting organism was permanently eradicated in 49% of the patients. In nine patients the organism developed resistance, particularly when the initial MIC was higher than 0.5 mg/l. No significant adverse reactions were observed. Ciprofloxacin is the first antipseudomonal antimicrobial agent which can be administered orally and therefore fulfills a need in chemotherapy.

Timentin therapy for bone, joint, and deep soft tissue infections in children

Timentin, a combination of clavulanic acid (0.1 g) and ticarcillin (3.0 g), has proved effective in vitro against bacterial pathogens that produce beta-lactamases. The usual etiologic bacteria of osteochondritis of the foot (Pseudomonas species) and osteomyelitis/ septic arthritis (Staphylococcus aureus) are commonly resistant to penicillins. To date, we have used Timentin to treat 30 children with bone, joint, and deep soft tissue infections. Timentin was administered intravenously at an average dosage of 207 mg/kg per day for mild to moderate infection and 310 mg/kg per day for bone and joint infections with systemic signs (sepsis). The lower dose was used in 24 patients and the other six patients, who had signs of sepsis, received the higher dose. All patients received Timentin intravenously over 30 minutes every four to six hours for a minimum of five days (mean 6.6±2.6 days, range five to 14 days). The mean time to defervescence and/or reduction in clinical symptoms was 1.6 ± 1.3 days (range zero to four days). Osteochondritis due to P. aeruginosa was diagnosed in six patients, and septic bursitis, osteomyelitis, or septic arthritis due to S. aureus (13 patients) or Staphylococcus species and group A streptococci (four patients) was diagnosed in 17 patients. All isolates were susceptible to Timentin in vitro by disk-diffusion analysis. All patients showed a response to therapy with Timentin, with or without surgical intervention. All patients had clinical and microbiologic cures; no adverse reactions or side effects were observed. There have been no clinical or microbiologic relapses to date. Timentin may prove to be useful in specific bone and joint infections in children.