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Related Concept Videos

Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
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Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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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...
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

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Related Experiment Videos

Twelve hundred abscesses operatively drained: an antibiotic conundrum?

Lisa Hall Zimmerman1, James G Tyburski, Alexander Stoffan

  • 1Department of Pharmacy Services, Detroit Receiving Hospital, Detroit, MI 48201, USA. lhall5@dmc.org

Surgery
|October 1, 2009
PubMed
Summary

Antimicrobial resistance is rising in soft tissue infections. This study found Staphylococcus aureus, particularly methicillin-resistant S aureus (MRSA), and anaerobes are common pathogens, necessitating broader empiric antibiotic coverage.

Related Experiment Videos

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Surgical Infections

Background:

  • Increasing incidence of soft tissue infections caused by antimicrobial-resistant pathogens.
  • Need to understand the epidemiology of operatively drained soft tissue abscesses.

Purpose of the Study:

  • To evaluate the epidemiology of pathogens in operatively drained soft tissue abscesses.
  • To assess the adequacy of empiric antibiotic therapy.

Main Methods:

  • Retrospective study of 1,200 patients undergoing incision and drainage (I&D) from 2002 to 2008.
  • Exclusion of perirectal or hidradenitis infections.
  • Analysis of intraoperative cultures from 1,005 patients.

Main Results:

  • Gram-positive aerobes (65%) and anaerobes (23%) were the most common pathogens.
  • Staphylococcus aureus, predominantly methicillin-resistant S aureus (MRSA) (80% of S. aureus), was the most prevalent organism.
  • Empiric antibiotic therapy (ampicillin/sulbactam) frequently failed to cover MRSA (82%), resistant gram-negative aerobes (24%), and anaerobes (26%).

Conclusions:

  • Gram-positive aerobes and anaerobes constitute a significant proportion of pathogens in soft tissue abscesses.
  • Empiric antibiotic regimens for superficial abscesses requiring surgical drainage should include coverage for MRSA and anaerobes.
  • Underestimation of anaerobic infections is possible.