Acute bacterial skin and skin-structure infection

Overview of acute bacterial skin and skin-structure infections

Acute Bacterial Skin and Skin-Structure Infection
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Synonyms	ABSSSI
Pronounce	N/A
Specialty	N/A
Symptoms	Redness, swelling, pain, warmth
Complications	Sepsis, necrotizing fasciitis
Onset	Sudden
Duration	Varies
Types	N/A
Causes	Bacterial infection
Risks	Diabetes, immunosuppression, chronic skin conditions
Diagnosis	Clinical examination, culture
Differential diagnosis	N/A
Prevention	N/A
Treatment	Antibiotics, surgical debridement
Medication	N/A
Prognosis	Generally good with treatment
Frequency	Common
Deaths	N/A

Acute bacterial skin and skin-structure infections (ABSSSI) are a group of infections that involve the skin and its underlying structures, such as the subcutaneous tissue, fascia, and muscle. These infections are typically caused by bacteria and can range from mild to severe. Common examples include cellulitis, erysipelas, and abscesses.

Etiology

ABSSSI are primarily caused by Gram-positive bacteria, with Staphylococcus aureus and Streptococcus pyogenes being the most common pathogens. Methicillin-resistant Staphylococcus aureus (MRSA) is a significant concern due to its resistance to many standard antibiotics.

Clinical Presentation

Patients with ABSSSI typically present with localized symptoms such as redness, swelling, pain, and warmth over the affected area. Systemic symptoms like fever and malaise may also be present, especially in more severe cases. The infection can progress rapidly, leading to complications such as necrotizing fasciitis or sepsis if not treated promptly.

Diagnosis

Diagnosis of ABSSSI is primarily clinical, based on the appearance of the skin and symptoms. Laboratory tests, such as blood cultures and wound cultures, can help identify the causative organism and guide antibiotic therapy. Imaging studies, like ultrasound or MRI, may be used to assess the extent of the infection.

Treatment

The mainstay of treatment for ABSSSI is antibiotic therapy. The choice of antibiotic depends on the suspected or confirmed pathogen and its antibiotic susceptibility profile. Commonly used antibiotics include cephalexin, clindamycin, and vancomycin for MRSA. In cases of abscess, surgical drainage is often necessary.

Prevention

Preventive measures include proper wound care, maintaining good hygiene, and managing underlying conditions such as diabetes that predispose individuals to infections. In healthcare settings, infection control practices are crucial to prevent the spread of resistant organisms like MRSA.

Prognosis

With appropriate treatment, the prognosis for most ABSSSI is good. However, complications can arise, particularly in immunocompromised individuals or those with delayed treatment.

Also see

• Cellulitis
• Erysipelas
• Necrotizing fasciitis
• Methicillin-resistant Staphylococcus aureus
• Sepsis