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Paper 3
Published in Aalia Khan, Ramsey Jabbour, Almas Rehman, nMRCGP Applied Knowledge Test Study Guide, 2021
Aalia Khan, Ramsey Jabbour, Almas Rehman
Breast abscess usually occurs in breast-feeding mothers due to acute mastitis. The patient is usually systemically unwell with fever and anorexia. The breast is warm to touch, with a tender swelling. The abscess may become fluctuant and discharge spontaneously. Antibiotics effective against Staphylococcus may be sufficient if given early, but incision and drainage may be necessary.
Atopic Dermatitis
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Luz Fonacier, Amanda Schneider
Occasionally AD lesions can become infected with Herpes Simplex Virus (HSV), which can be diagnosed via viral PCR, Tczank preps or culture from unroofed intact vesicles. These cases respond well to antiviral therapy (Boguniewicz and Leung 2006). In addition to bacterial and viral superinfections, Malassezia species infection can occur commonly in the seborrheic areas of the head and neck. Sensitization to M. sympodialis can be detected via ImmunoCAP assay. Antifungal therapy (topical or rarely systemic) has been effective in these patients (Boguniewicz et al. 2006). Since colonization with S. aureus can exacerbate acute AD and promote chronic skin inflammation, use of anti-staphylococcal therapy should be considered in poorly controlled AD with evidence of infection. Systemic antibiotics should be reserved for those that are heavily colonized or infected when it is clear that infection with S. aureus is a trigger. Erythromycin-resistant organisms are common, thus semi synthetic penicillins or first- or second- generation cephalosporins for 7 to 10 days can be effective (Boguniewicz et al. 2001). If Methacillin Resistant Staphylococcus aureus (MRSA) colonization exists, clindamycin, or trimethoprimsulfamethoxazole and intranasal Mupirocin can be used. Topical Mupirocin three times daily for 7 to 10 days may be effective. The combination of topical corticosteroids and topical Mupirocin has been shown to be more effective than corticosteroids alone in achieving skin clearance and decreased colonization of S. aurueus (Lever et al. 1988).
Skin
Published in Keith Hopcroft, Vincent Forte, Symptom Sorter, 2020
Small print: Investigations to assess for any underlying cause of acanthosis nigricans. Skin scrapings: Occasionally needed to confirm a fungal infection if this is in doubt.Swabs: Occasionally needed to confirm a suspected staphylococcal infection.Investigations to assess for any underlying cause of acanthosis nigricans: This condition is associated with a number of systemic conditions, which might require investigation, depending on the clinical circumstance. This might involve HbA1c or blood sugar for diabetes, LH, FSH, testosterone, SHBG and pelvic ultrasound for PCOS, and hospital-based investigations if an underlying malignancy (especially gastrointestinal) is suspected.
Analysis of microbial communities of ocular prostheses and anophthalmic sockets using 16S rRNA gene sequencing
Published in Biofouling, 2023
L. R Makrakis, V. C Oliveira, E. S Santos, C Nascimento, E Watanabe, A. B Ribeiro, C. H Silva-Lovato
Even though the approaches mentioned above are undoubtedly important for maintaining ocular prostheses, it is important to consider that significant physiological and morphological changes occur after eye loss (Pine et al. 2011; Wang et al. 2020; Penitente et al. 2022). Most users complained of secretion accumulation and frequent irritation in the anophthalmic socket (Pine et al. 2011). These factors could favor bacterial colonization by providing a niche for microorganism growth and contributing to patients handling the prosthesis over time. Biofilm formation on the prostheses surface and colonization of the anophthalmic socket by pathogenic microorganisms are factors that are supposed to lead to conjunctival infections and increased discomfort (Toribio et al. 2017; Penitente et al. 2022; Zhao et al. 2023). Even though recent findings have shown a high incidence of Staphylococcus spp. in anophthalmic socket patients (Toribio et al. 2019; Penitente et al. 2022), the microbiota of the ocular prosthesis and anophthalmic socket is poorly understood, which is reflected in the scarcity of publications in the field.
Bioprospecting of aqueous phase from pyrolysis of plant waste residues to disrupt MRSA biofilms
Published in Biofouling, 2023
Srividhya Krishnan, Subramaniyasharma Sivaraman, Sowndarya Jothipandiyan, Ponnusami Venkatachalam, Saravanan Ramiah Shanmugam, Nithyanand Paramasivam
Staphylococcus aureus, is a well-known human pathogen, which causes infection upon colonization with varying degree of infectivity from mild skin irritation to pneumonia, mostly, spreading in healthcare and hospital environments. Hospital equipment and surfaces (which included door handles, floors, bed surfaces, stethoscopes, etc.) have been reported to be colonised with S. aureus isolates (Jabłońska-Trypuć et al. 2022). Studies also show that S. aureus can remain viable on dry surfaces over a time period of 1 week to 3 years (Chaibenjawong and Foster 2011). The major contact surfaces in hospitals are plastic (polyvinyl or polypropylene) surfaces, ceramic tiles and stainless-steel surfaces. These pathogens survive under hospital conditions depending on the porosity, free surface, hydrophobicity, adhesion and biofilm formation ability (Sinde and Carballo 2000; Donlan 2001, 2002). It is also reported that stainless steel promotes easy formation of biofilm and plastic surfaces can act as a source of disease transmission from inanimate surfaces (Lagha et al. 2015).
MRSA Decolonization and the Eye: A Potential New Tool for Ophthalmologists
Published in Seminars in Ophthalmology, 2022
Jeremy B Hatcher, Alex de Castro-Abeger, Richard W LaRue, Melanie Hingorani, Louise Mawn, Sean P Donahue, Paul Sternberg, Christine Shieh
Methicillin-Resistant Staphylococcus Aureus (MRSA) is an opportunistic pathogen resistant to several antibiotics commonly used to treat Staphylococcus aureus. The rise in prevalence of both hospital- and community-acquired MRSA strains in the early twenty-first century is attributed to widespread antibiotic use in prior decades, leading to international challenges with multi-drug resistance.1 The ecologic niche of MRSA in humans is the anterior nares. Healthy individuals may be “colonized” with MRSA but without active clinical infection. However, MRSA colonization plays a key role in the epidemiology and pathogenesis of disease in the body, with patterns of increased persistent nasal carriage in immunocompromised patients.2 MRSA is also readily transmitted between patients. Risk factors for MRSA carriage include advanced age, prior or recent hospital admission, and residence in a nursing home. Once considered a nosocomial pathogen, surveillance studies have noted the increasing prevalence of community-acquired MRSA isolates.2,3 MRSA infections affect the care of patients in all medical settings, complicating medical care in the inpatient setting (particularly the intensive care unit), operating room and the outpatient clinics. Some authors have even gone as far as to call for universal MRSA screening in adults admitted through the Emergency Department.4 Evidence suggests that up to 1/4 of colonized patients may develop an MRSA infection within a year of being identified as MRSA-colonized.5