Role of antibiotics
Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor in Essentials of Anesthesia for Neurotrauma, 2018
Relatively few published studies have reported the results of bacteriologic analysis of removed fragments or the causative agents of infection in PBIs. The main microbiologic studies were conducted on samples cultured during the Vietnam War and the Iran–Iraq War. Most of the contaminating organisms were skin flora such as Staphylococcus epidermidis, but Staphylococcus aureus and gram-negative bacilli were also common pathogens, as reported in Table 17.1. Nevertheless most of these studies do not describe the results of anaerobic cultures and do not differentiate between colonization and infection. Furthermore, the quality of the microbiology did not equal modern standards, so most isolates cannot be considered to have been conclusively identified.21
Commensal Flora
Firza Alexander Gronthoud in Practical Clinical Microbiology and Infectious Diseases, 2020
The bacterial flora on the skin protects individuals against colonization by pathogens. Conversely, skin flora can become pathogenic if the organisms penetrate the skin (e.g. when there is a wound). Cellulitis and erysipelas are predominantly caused by S. aureus and Streptococcus pyogenes. Staphylococcus epidermidis is a common skin colonizer and not associated with wound infections. However, this species may cause bloodstream infections in the presence of indwelling devices. Patients who receive chemotherapy for treatment of their underlying malignancy are at risk for mucositis, which increases the risk of bacterial translocation with gut flora. Patients with graft-versus-host disease affecting the skin or gut are at risk for infection.
Iatrogenic spinal infections
Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni in Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
The gold standard to diagnose infection is by culture obtained intraoperatively under sterile conditions (Bassewitz et al., 2000). Such cultures are not only helpful to diagnose infection, but also identify a specific pathogen and its drug sensitivities (Bassewitz et al., 2000). Treatment options can be selected based on these sensitivities. Cultures obtained at the bedside by probing an open wound are generally contaminated by skin flora and are of little utility.
Recent advancements in cellulose-based biomaterials for management of infected wounds
Published in Expert Opinion on Drug Delivery, 2021
Munira Momin, Varsha Mishra, Sankalp Gharat, Abdelwahab Omri
One of the major obstacles to wound healing is the possibility of infection. Bacteria are widespread in the skin flora and, as a result, in wounds. A threshold of 105 bacteria has been proposed as a distinction between colonization and a clinically significant infection that can hamper wound healing. Chronic wounds are often affected by infection. Chronic wounds like diabetic ulcer or wounds resulting from peripheral vascular disease have more necrotic debris, which facilitate bacterial growth. In most cases, the immune system is compromised which limits the ability of the body to combat these bacterial growths [18]. It is estimated that around 60% of chronic infections are caused due to biofilm formation [16,19]. The bacteria S. aureus, Beta-hemolytic Streptococcus, Escherichia coli, Proteus, Klebsiella, Pseudomonas aeruginosa, Acinetobacter, Stenotrophomonas (Xanthomonas) are responsible for a number of chronic wound infections [2]
Symbiotic microorganisms: prospects for treating atopic dermatitis
Published in Expert Opinion on Biological Therapy, 2022
Rongrong Chai, Zongguang Tai, Yunjie Zhu, Chaochao Chai, Zhongjian Chen, Quangang Zhu
The skin flora is the most diverse in the human body and is crucial for host defense. The commensal skin flora protects the host from harmful pathogens and participates in the delicate balance of the immune system between effective protection and destructive inflammation [12]. The skin flora can synthesize and release compounds, such as histamine, glutamate, and gamma-aminobutyric acid, or peptides, such as alpha-melanocyte stimulating hormone. Some viruses encode neurohormone-mimicking proteins, which may be considered neurohormonal by organisms [89]. Highly inflammatory cytolysins and antimicrobial peptides are secreted by the skin flora, which have an obvious relationship with the skin microenvironment [90,91]. Thus, skin flora dysbiosis is a risk factor for the development or aggravation of skin diseases [92].
Infected penile prosthesis: literature review highlighting the status quo of prevention and management
Published in The Aging Male, 2020
Tariq F. Al-Shaiji, Said M. Yaiesh, Abdullatif E. Al-Terki, Faisal M. Alhajeri
Infection of penile prosthesis is a non-conventional surgical infection of the implantable device. Skin flora are more common causative organisms of the infection, but the trends are shifting with antibiotic resistance. Risk factors include immunocompromised status of the patient, spinal injuries and paraplegia, and DM until proven otherwise. No strict formal guidelines on prevention and treatment of such infections have been published by reputable urological authorities, but sporadic recommendations exist. Prevention includes extensive preoperative preparation and optimization of medical comorbidities including diabetes status of the patient undergoing the implantation and appropriate antimicrobial coverage perioperatively. When acute IPP is suspected, MRI is the imaging of choice for diagnosis and surgical planning. The Mulcahy salvage procedure remains the most popular method of revision for infected penile prostheses, but other techniques and variations have been described with comparable success outcomes. Nevertheless, there is an emerging role for conservative management of these infections and efforts to prevent their occurrence in the first place with the no-touch technique and other pre- and peri-operative protocols. Further studies are called for to better understand the pathology and impact of such infections, with a stress on the need for assembly of professional panels to set guidelines for practitioners to tackle such a highly morbid complication.
Related Knowledge Centers
- Bacteria
- Commensalism
- Epidermis
- Hair Follicle
- Microbiota
- Mutualism
- Immune System
- Skin
- Pathogen
- Skin Condition