Skin and soft-tissue infections: impact of resistant gram-positive bacteria

Mark A Wilson1

  • 1Veterans Administration Pittsburgh Healthcare System and Department of Surgery, University of Pittsburgh, University Drive C (112), Pittsburgh, Pennsylvania 15230, USA.

American Journal of Surgery
|December 20, 2003
PubMed

Insights

Surgical site infections (SSIs) pose risks despite advances. Increasing gram-positive bacteria and drug resistance necessitate enhanced prevention strategies beyond new antibiotics.

Area of Science:

  • Infectious Diseases
  • Surgical Outcomes
  • Antimicrobial Resistance

Background:

  • Surgical site infections (SSIs) are a major cause of postoperative complications.
  • Despite advances in antimicrobial agents, SSIs remain a significant concern.
  • The prevalence of gram-positive bacteria and drug-resistant strains in SSIs is increasing.

Purpose of the Study:

  • To highlight the persistent challenge of surgical site infections.
  • To emphasize the growing issue of gram-positive bacteria and antimicrobial resistance in SSIs.
  • To advocate for comprehensive infection prevention strategies in surgical settings.

Main Methods:

  • Review of current literature on surgical site infections.
  • Analysis of trends in SSI causative agents and antimicrobial resistance.
  • Discussion of established and novel infection control measures.

Main Results:

  • Overall SSI rates are decreasing, but the proportion of gram-positive infections is rising.
  • Drug-resistant bacterial species are becoming more prevalent in SSIs.
  • New antibiotics offer temporary solutions to multidrug resistance.

Conclusions:

  • Surgeons must prioritize SSI prevention through appropriate antibiotic use.
  • Strict adherence to infection control principles is crucial.
  • Exploring and implementing nontraditional measures can further reduce SSI risk.

Related Concept Videos

Clinical Significance of Antibiotic Resistance01:25

Clinical Significance of Antibiotic Resistance

Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Staphylococcal Skin Infections01:29

Staphylococcal Skin Infections

Staphylococcus aureus is a Gram-positive coccus that resides harmlessly on the skin and mucous membranes of healthy individuals. When the skin barrier is breached, it can shift from a commensal to an opportunistic pathogen. This transition is facilitated by surface adhesins, such as clumping factor B and S. aureus surface protein G (SasG), which bind to structural proteins, including loricrin and cytokeratin, in the damaged epidermis. Protein A, another key factor, binds the Fc region of...
Mechanism of Antibiotic Resistance in MRSA01:25

Mechanism of Antibiotic Resistance in MRSA

Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
Skin Diseases and Disorders01:23

Skin Diseases and Disorders

Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
Factors Affecting the Risk of Infection01:26

Factors Affecting the Risk of Infection

The hosts' susceptibility to infection depends on several factors. The integrity of the skin and mucous membranes helps protect the body against microbial attacks. When the skin is altered, the chance of infection, limb loss, and even death increases.
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...
Development of Antibiotic Resistance01:30

Development of Antibiotic Resistance

Antibiotic resistance is a major public health concern that arises when bacteria evolve mechanisms to withstand the effects of antibiotic treatments. This resistance can be intrinsic, acquired through genetic mutations, or transferred between bacteria via horizontal gene transfer. The development of antibiotic resistance poses significant challenges in treating bacterial infections and necessitates ongoing research to develop new therapeutic strategies.Intrinsic resistance occurs when bacterial...