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Poren Hsueh - One of the best experts on this subject based on the ideXlab platform.

  • characteristics of skin and Soft Tissue Infection caused by non tuberculous mycobacteria in taiwan
    International Journal of Tuberculosis and Lung Disease, 2011
    Co-Authors: Chenghsiang Hsiao, Tsenfang Tsai, Poren Hsueh
    Abstract:

    SETTING: A medical centre in Taipei, Taiwan. OBJECTIVE: To investigate the clinicopathological and microbiological correlates of skin and Soft Tissue Infection (SSTI) due to non-tuberculous mycobacteria (NTM). DESIGN: Patients with NTM SSTI identified from 1999 to 2009 were included. Histological sections of the skin biopsy specimens from these patients were reassessed. RESULTS: Among 58 patients with NTM SSTI, the most commonly isolated NTM were rapidly growing mycobacteria (RGM; n = 30), Mycobacterium marinum (n = 17) and M. avium complex (MAC) (n = 4). Twenty-nine (50%) of the NTM SSTI involved deep Soft Tissue; these progressed to local tenosynovitis in 20 patients. All of the cutaneous lesions infected with M. marinum occurred on the upper extremities; in 9 patients the skin eruptions developed after injury in an aquatic environment. Skin lesions with RGM Infection usually occurred on the lower extremities, and in 6 patients the Infection developed from wounds caused by medical procedures. Granulomatous inflammation with fibrinoid necrosis was present in 47% of lesions in patients with M. marinum Infection and suppurative granulomatous inflammation was noted in 45% of patients with RGM Infection. CONCLUSIONS: Identification of a close clinicopathological correlate is useful for dermatologists and pathologists in the early diagnosis and treatment of NTM SSTI.

  • skin and Soft Tissue Infection caused by non tuberculous mycobacteria in taiwan 1997 2008
    Epidemiology and Infection, 2011
    Co-Authors: Horngshyang Chen, Chinghsiang Chen, Chunta Huang, Shengyuan Ruan, Chienhong Chou, Chienhung Liao, Y T Huang, Chongjen Yu, Poren Hsueh
    Abstract:

    The aim of this study was to investigate the clinical, microbiological, and pathological characteristics and the outcomes of skin and Soft-Tissue Infection (SSTI) caused by non-tuberculous mycobacteria (NTM). Medical records of 50 patients with SSTI caused by NTM identified from 2005 to 2008 and 63 patients previously reported in a medical centre from 1997 to 2004 were reviewed. The annual incidence (per 100 000 outpatients and in-patients) ranged from 0·57 in 2005, 0·38 in 2007, to 1·1 in 2008, with an average of 0·62/100 000. From 1997 to 2008, the average incidence was 1·39/100 000 patients. The average annual incidence of SSTI caused by NTM was 0·62/100 000 outpatients and in-patients during 2005 and 2008. Of the total of 113 patients identified during the 12-year period, patients infected with Mycobacterium fortuitum and M. marinum were younger than those infected with M. avium-intracellulare complex (MAC) (36 and 44 years vs . 55 years, P =0·004 and P =0·056, respectively), and were more likely to have previous invasive procedures than those infected with MAC and M. abscessus (81·8% and 72·0% vs . 27·8% and 54·8%, P =0·007), and less likely to have associated immunosuppression (9·1% and 24% vs . 66·7% and 45·2%, P =0·006). Granuloma was more often observed in immunocompetent patients (60·1% vs . 40%, P =0·019), and in M. marinum -infected specimens (78·3%). There were significant differences in the demographic and clinical features of patients with NTM SSTI, including immunosuppression, trauma experience, and depth of Tissue Infections.

Benjamin A. Lipsky - One of the best experts on this subject based on the ideXlab platform.

  • Staphylococcus aureus Soft Tissue Infection may increase the risk of subsequent staphylococcal Soft Tissue Infections
    International Journal of Infectious Diseases, 2017
    Co-Authors: Cindy Bouvet, Shpresa Gjoni, Besa Zenelaj, Benjamin A. Lipsky, Elif Hakko, Ilker Uckay
    Abstract:

    Summary Background Staphylococcus aureus is the most common cause of Soft Tissue Infections. It is unknown, however, if a patient who has had such an Infection is at greater risk for future Soft Tissue Infections with S. aureus . Methods We conducted an epidemiological survey of adult patients hospitalized in the only public hospital in Geneva for treatment (usually combined surgical and medical) of a Soft Tissue Infection caused by S. aureus . By reviewing nursing and medical records from the emergency department and hospital wards, we assessed whether or not they developed any other Soft Tissue Infections (excluding a recurrence) after or before the index one. Results Among 1023 index episodes of Soft Tissue Infections, 670 (65%) were caused by S. aureus, of which 47 were caused by methicillin-resistant strains (30 healthcare-associated and 17 community-acquired). The patients' median age was 51 years and 334 (34%) were immune-compromised. The median time span between the patient's first and last consultation (for any reason) in our hospital was 21.4 years (interquartile range, 10-30 years). In addition to their index Infection, 124 patients (12%) developed a new nosocomial or community-acquired Soft Tissue Infection. Among the index cases with an S. aureus Infection, 92 (14%) had another Soft Tissue Infection, compared to 32 (9%) who had a non-staphylococcal index Infection (Pearson-χ 2 -test; p =0.03). Similarly, patients with an index S. aureus Infection, compared to those with a non- S. aureus Infection, had a higher rate of another Soft Tissue Infection caused by S. aureus (χ 2 -test; p 0.01). In multivariate analysis, an index Infection due to S. aureus shows a high association to further S. aureus Soft Tissue Infections (logistic regression; odds ratio 2.5, 95% confidence interval 1.4-4.6). Conclusion Among adult patients hospitalised for a Soft Tissue Infection, those infected with S. aureus (compared with other pathogens) may be at higher risk of a subsequent Soft Tissue Infection, particularly with S. aureus .

  • diagnosing diabetic foot osteomyelitis in patients without signs of Soft Tissue Infection by coupling hybrid 67ga spect ct with bedside percutaneous bone puncture
    Diabetes Care, 2013
    Co-Authors: E Aslangul, Benjamin A. Lipsky, J Mbemba, N Caillatvigneron, Sophie Coignard, Etienne Larger, Christian Boitard
    Abstract:

    OBJECTIVE: Successful treatment of osteomyelitis is more likely with accurate diagnosis and identification of the causative pathogens. This typically requires obtaining a specimen of bone, usually by image-guided biopsy. We sought to develop a simpler bedside method for definitively diagnosing osteomyelitis. RESEARCH DESIGN AND METHODS: Over 2 years, we enrolled consecutive patients presenting to our diabetic foot clinic with a foot ulcer and clinically suspected osteomyelitis but without Soft Tissue Infection. Each underwent hybrid (67)Ga single-photon emission computed tomography and X-ray computed tomography (SPECT/CT) imaging; those with a positive scan underwent bedside percutaneous bone puncture. Patients with a positive bone culture received culture-guided antibiotic therapy. Patients with negative (67)Ga SPECT/CT imaging or with positive imaging but negative bone culture were not treated with antibiotics. All patients were followed up for ≥ 1 year. RESULTS: Among 55 patients who underwent (67)Ga SPECT/CT imaging, 13 had negative results and all of their foot ulcers resolved without antibiotic therapy. Among 42 with positive imaging, 2 were excluded (for recent antibiotic therapy) and 40 had bone punctures (3 punctured twice): 19 had negative results, 3 of which were likely false negatives, and 24 had positive results (all gram-positive cocci). At follow-up, 3 patients had died, 3 had undergone amputation, and 47 had no evidence of foot Infection. The sensitivity and specificity of this combined method were 88.0 and 93.6%, respectively, and the positive and negative predictive values were 91.7 and 90.7%, respectively. CONCLUSIONS: Coupling of (67)Ga SPECT/CT imaging and bedside percutaneous bone puncture appears to be accurate and safe for diagnosing diabetic foot osteomyelitis in patients without signs of Soft Tissue Infection, obviating the need for antibiotic treatment in 55% of suspected cases.

Jacobus H De Waard - One of the best experts on this subject based on the ideXlab platform.

  • source investigation of two outbreaks of skin and Soft Tissue Infection by mycobacterium abscessus subsp abscessus in venezuela
    Epidemiology and Infection, 2016
    Co-Authors: J A Torrescoy, Barbara A Rodriguezcastillo, Ricardo Perezalfonzo, Jacobus H De Waard
    Abstract:

    Outbreaks of Soft Tissue or skin Infection due to non-tuberculous mycobacteria are reported frequently in scientific journals but in general the Infection source in these outbreaks remains unknown. In Venezuela, in two distinct outbreaks, one after breast augmentation surgery and another after hydrolipoclasy therapy, 16 patients contracted a Soft Tissue Infection due to Mycobacterium abscessus subsp. abscessus. Searching for the possible environmental Infection sources in these outbreaks, initially the tap water (in the hydrolipoclasy therapy outbreak) and a surgical skin marker (in the breast implant surgery outbreak), were identified as the Infection sources. Molecular typing of the strains with a variable number tandem repeat typing assay confirmed the tap water as the Infection source but the molecular typing technique excluded the skin marker. We discuss the results and make a call for the implementation of stringent hygiene and disInfection guidelines for cosmetic procedures in Venezuela.

  • Soft Tissue Infection due to mycobacterium fortuitum following acupuncture a case report and review of the literature
    Journal of Infection in Developing Countries, 2010
    Co-Authors: Armando Guevarapatino, Marisol Sandovalde Mora, Aileen Farreras, Ismar A Riveraolivero, Danibeth Fermin, Jacobus H De Waard
    Abstract:

    We report the first case of a post-acupuncture Soft Tissue Infection due to Mycobacterium fortuitum . Two months after finishing an acupuncture treatment session, an immunocompetent 23-year-old woman developed cellulitis at the side of the needle insertions and the acid-fast bacillus was isolated from a closed abscess. The patient was successfully treated with a proper drug combination. We review the literature concerning the Infection source and the risks for skin and Soft Tissue Infection due to mycobacteria after acupuncture. The Infection source in most cases is unknown but is probably associated with the inadequate sterilization of the needles or the puncture site. We show that these Infections are not rare but difficult to diagnose. To avoid delays in the definitive diagnosis, Infection with mycobacteria should be considered for skin and Soft Tissue Infections, in particular late-onset Infections, which are negative for routine bacterial cultures and without a clinical response to antibiotics used for acute pyogenic Infections. Bacterial cultures from this lesion should be maintained for at least six weeks before discharged as negative.

Frank R Deleo - One of the best experts on this subject based on the ideXlab platform.

  • contribution of staphylococcus aureus coagulases and clumping factor a to abscess formation in a rabbit model of skin and Soft Tissue Infection
    PLOS ONE, 2016
    Co-Authors: Natalia Malachowa, Scott D Kobayashi, Kevin R Braughton, Donald J Gardner, Olaf Schneewind, Adeline R Porter, Dana P Scott, Dominique Missiakas, Frank R Deleo
    Abstract:

    Staphylococcus aureus produces numerous factors that facilitate survival in the human host. S. aureus coagulase (Coa) and von Willebrand factor-binding protein (vWbp) are known to clot plasma through activation of prothrombin and conversion of fibrinogen to fibrin. In addition, S. aureus clumping factor A (ClfA) binds fibrinogen and contributes to platelet aggregation via a fibrinogen- or complement-dependent mechanism. Here, we evaluated the contribution of Coa, vWbp and ClfA to S. aureus pathogenesis in a rabbit model of skin and Soft Tissue Infection. Compared to skin abscesses caused by the Newman wild-type strain, those caused by isogenic coa, vwb, or clfA deletion strains, or a strain deficient in coa and vwb, were significantly smaller following subcutaneous inoculation in rabbits. Unexpectedly, we found that fibrin deposition and abscess capsule formation appear to be independent of S. aureus coagulase activity in the rabbit Infection model. Similarities notwithstanding, S. aureus strains deficient in coa and vwb elicited reduced levels of several proinflammatory molecules in human blood in vitro. Although a specific mechanism remains to be determined, we conclude that S. aureus Coa, vWbp and ClfA contribute to abscess formation in rabbits.

  • comparative analysis of usa300 virulence determinants in a rabbit model of skin and Soft Tissue Infection
    The Journal of Infectious Diseases, 2011
    Co-Authors: Scott D Kobayashi, Natalia Malachowa, Adeline R Whitney, Kevin R Braughton, Donald J Gardner, Dan Long, Juliane Bubeck Wardenburg, Olaf Schneewind, Michael Otto, Frank R Deleo
    Abstract:

    Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) Infections are frequently associated with strains harboring genes encoding Panton-Valentine leukocidin (PVL). The role of PVL in the success of the epidemic CA-MRSA strain USA300 remains unknown. Here we developed a skin and Soft Tissue Infection model in rabbits to test the hypothesis that PVL contributes to USA300 pathogenesis and compare it with well-established virulence determinants: alpha-hemolysin (Hla), phenol-soluble modulin-alpha peptides (PSMα), and accessory gene regulator (Agr). The data indicate that Hla, PSMα, and Agr contribute to the pathogenesis of USA300 skin Infections in rabbits, whereas a role for PVL could not be detected.

Christina Hermos - One of the best experts on this subject based on the ideXlab platform.

  • high levels of antibody to panton valentine leukocidin are not associated with resistance to staphylococcus aureus associated skin and Soft Tissue Infection
    Clinical Infectious Diseases, 2010
    Co-Authors: Christina Hermos, Pauline Yoong, Gerald B Pier
    Abstract:

    In the last decade, Infection with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has increased in both adults and children [1-5]. CA-MRSA causes skin and Soft Tissue Infection (SSTI) and, less commonly, necrotizing pneumonia and other invasive Infections in otherwise healthy patients [2, 3, 6, 7]. In the United States, S. aureus type USA 300 accounts for the majority of CA-MRSA, and along with other CA-MRSA types, characteristically produces Panton-Valentine leukocidin (PVL) [6, 8-12]. While purified PVL, composed of proteins LukS and LukF, has clear pore-forming cytotoxic activity on human polymorphonuclear cells (PMNs), its role in pathogenesis remains controversial. Animal studies have indicated a pathogenic role [13-15], no effect [16-18] or even an anti-virulence role [19, 20]. The LukS component, within a multivalent vaccine, is under phase 1 clinical trials in humans [21]. We evaluated the levels of antibody to PVL in uninfected children and in children with MRSA SSTI and invasive Infections to determine if cytotoxic-neutralizing antibodies to PVL were associated with resistance to Infection.