scholarly journals Recognizing Common Skin and Soft Tissue Infections in the Nephrology Clinic

2018 ◽  
Vol 47 (1-3) ◽  
pp. 259-264 ◽  
Author(s):  
Karen M.  Van de Velde-Kossmann
Keyword(s):  
Renal Failure ◽  
Soft Tissue ◽  
Early Recognition ◽  
Soft Tissue Infections ◽  
Patient Morbidity ◽  
Cost Of Health Care ◽  
Increased Risk ◽  
Patient Health ◽  
Common Skin ◽  
The Cost

Renal failure patients have an increased risk of infection, including skin and soft tissue infections. This increased susceptibility is multifactorial, due to the conditions causing the renal failure as well as complications of treatment and renal failure’s innate effects on patient health. These infections have a significant impact on patient morbidity, increased hospital and procedural demands, and the cost of health care. Many renal failure patients are seen regularly by their nephrology clinic caregivers due to the need for frequent dialysis and transplant monitoring. Familiarity with common skin and soft tissue infections by these caregivers allowing enhanced patient education, optimal infection prevention, and early recognition could significantly reduce the morbidity and cost of these disorders, such as diabetic foot syndrome, necrotizing fasciitis, and herpetic infections.

Risk of serious infections in tocilizumab versus other biologic drugs in patients with rheumatoid arthritis: a multidatabase cohort study

2019 ◽  
Vol 78 (4) ◽  
pp. 456-464 ◽  
Author(s):  
Ajinkya Pawar ◽  
Rishi J Desai ◽  
Daniel H Solomon ◽  
Adrian J Santiago Ortiz ◽  
Sara Gale ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Soft Tissue ◽  
Bacterial Infection ◽  
Opportunistic Infection ◽  
Soft Tissue Infections ◽  
Upper Respiratory Tract ◽  
Biologic Drugs ◽  
Increased Risk ◽  
Biologic Drug

ObjectiveTo investigate the rate of serious bacterial, viral or opportunistic infection in patients with rheumatoid arthritis (RA) starting tocilizumab (TCZ) versus tumour necrosis factor inhibitors (TNFi) or abatacept.MethodsUsing claims data from US Medicare from 2010 to 2015, and IMS and MarketScan from 2011 to 2015, we identified adults with RA who initiated TCZ or TNFi (primary comparator)/abatacept (secondary comparator) with prior use of ≥1 different biologic drug or tofacitinib. The primary outcome was hospitalised serious infection (SI), including bacterial, viral or opportunistic infection. To control for >70 confounders, TCZ initiators were propensity score (PS)-matched to TNFi or abatacept initiators. Database-specific HRs were combined by a meta-analysis.ResultsThe primary cohort included 16 074 TCZ PS-matched to 33 109 TNFi initiators. The risk of composite SI was not different between TCZ and TNFi initiators (combined HR 1.05, 95% CI 0.95 to 1.16). However, TCZ was associated with an increased risk of serious bacterial infection (HR 1.19, 95% CI 1.07 to 1.33), skin and soft tissue infections (HR 2.38, 95% CI 1.47 to 3.86), and diverticulitis (HR 2.34, 95% CI 1.64 to 3.34) versus TNFi. An increased risk of composite SI, serious bacterial infection, diverticulitis, pneumonia/upper respiratory tract infection and septicaemia/bacteraemia was observed in TCZ versus abatacept users.ConclusionsThis large multidatabase cohort study found no difference in composite SI risk in patients with RA initiating TCZ versus TNFi after failing ≥1 biologic drug or tofacitinib. However, the risk of serious bacterial infection, skin and soft tissue infections, and diverticulitis was higher in TCZ versus TNFi initiators. The risk of composite SI was higher in TCZ initiators versus abatacept.

Skin and Soft Tissue Infections

2012 ◽  
pp. 341-350
Author(s):  
Imad M Tleyjeh ◽  
Larry M Baddour
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Skin Infection ◽  
Subcutaneous Tissue ◽  
Clinical Manifestations ◽  
Hair Follicles ◽  
Soft Tissue Infections ◽  
Exposed Skin ◽  
Common Skin ◽  
The Face

Common skin and soft tissue infections covered in this chapter include impetigo, folliculitis, furuncles, carbuncles, cellulitis, and necrotizing fasciitis. Impetigo is a superficial pustular skin infection. Multiple lesions occur on exposed skin of the face and extremities. Staphylococcus aureus causes most cases. Folliculitis is a superficial skin infection of hair follicles. A furuncle is a purulent, painful nodular skin infection involving the hair follicle that is usually a complication of folliculitis. A carbuncle is a cluster of abscesses in subcutaneous tissue that drain through hair follicles. The prevailing pathogen for both furuncles and carbuncles is S aureus. Skin abscesses involve the dermis and deeper skin tissues. Often a pustule is present on the skin. For most cases the pathogen is S aureus. Cellulitis involves skin and subcutaneous tissues. Clinical manifestations of cellulitis include swelling, erythema, tenderness, and warmth. Necrotizing forms of cellulitis are necrotizing fasciitis types I and II. Clinical features include fulminant destruction of tissue and systemic toxicity.

Rocuronium is associated with an increased risk of reintubation in patients with soft tissue infections

2016 ◽  
Vol 34 ◽  
pp. 186-191 ◽  
Author(s):  
Karla M. Greco ◽  
Bianca M. Conti ◽  
Cynthia J. Bucci ◽  
Samuel M. Galvagno
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Infections ◽  
Increased Risk

scholarly journals Correlation between Nasal Microbiome Composition and Remote Purulent Skin and Soft Tissue Infections

2014 ◽  
Vol 83 (2) ◽  
pp. 802-811 ◽  
Author(s):  
Ryan C. Johnson ◽  
Michael W. Ellis ◽  
Jeffrey B. Lanier ◽  
Carey D. Schlett ◽  
Tianyuan Cui ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Inverse Correlation ◽  
Valuable Insight ◽  
Soft Tissue Infections ◽  
Content Type ◽  
16S Sequencing ◽  
Microbiome Composition ◽  
The Past ◽  
Increased Risk ◽  
Insight Into

The incidence of skin and soft tissue infections (SSTIs) has increased dramatically over the past decade, resulting in significant morbidity in millions of otherwise healthy individuals worldwide. Certain groups, like military personnel, are at increased risk for SSTI development. Although nasal colonization withStaphylococcus aureusis an important risk factor for the development of SSTIs, it is not clear why some colonized individuals develop disease while others do not. Recent studies have revealed the importance of microbial diversity in human health. Therefore, we hypothesized that the nasal microbiome may provide valuable insight into SSTI development. To examine this hypothesis, we obtained anterior-naris samples from military trainees with cutaneous abscesses and from asymptomatic (non-SSTI) participants. We also obtained samples from within abscess cavities. Specimens were analyzed by culture, and the microbial community within each sample was characterized using a 16S sequencing-based approach. We collected specimens from 46 non-SSTI participants and from 40 participants with abscesses. We observed a significantly higher abundance ofProteobacteriain the anterior nares in non-SSTI participants (P< 0.0001) than in participants with abscesses. Additionally, we noted a significant inverse correlation betweenCorynebacteriumspp. andS. aureus(P= 0.0001). The sensitivity of standard microbiological culture for abscesses was 71.4%. These data expand our knowledge of the complexity of the nasal and abscess microbiomes and potentially pave the way for novel therapeutic and prophylactic countermeasures against SSTI.

scholarly journals 108. Evaluation of the Impact of Dalbavancin Usage on Clinical Outcomes, Cost-Savings, and Adherence at a Large Safety Net Hospital

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S168-S168
Author(s):  
Wenjing Wei ◽  
Norman Mang ◽  
Jessica Ortwine ◽  
Jessica A Meisner ◽  
Richard Lueking
Keyword(s):  
Soft Tissue ◽  
Length Of Stay ◽  
Cost Savings ◽  
Safety Net ◽  
Separate Analysis ◽  
Soft Tissue Infections ◽  
Increased Risk ◽  
Safety Net Hospital ◽  
Long Acting ◽  
The Impact

Abstract Background Dalbavancin is a long-acting second-generation lipoglycopeptide antibiotic with potent activity against Gram-positive organisms. Dalbavancin is currently FDA approved for acute bacterial skin and soft tissue infections (ABSSTIs). Growing evidence suggests that patients can be successfully treated with dalbavancin for indications outside of skin and soft tissue infections which include bacteremia and osteomyelitis (OM) with significant cost savings and reduced length of stay. We developed a protocol for the use of dalbavancin in patients who required intravenous antibiotics for serious bacterial infections but did not qualify for outpatient parenteral antibiotic therapy (OPAT). During the COVID-19 pandemic, we expanded the protocol to reduce the amount of clinical contact required for all patients. Methods In this retrospective observational study, we reviewed all patients that received at least one dose of dalbavancin in either inpatient or outpatient setting at Parkland Hospital from July 2019 through February 2021. Patient demographics, type of infection, and rationale for dalbavancin were collected at baseline. Clinical response was measured by avoidance of Emergency Department (ED) visits or hospital readmission at 30, 60, and 90 days. In addition, a separate analysis was conducted to estimate hospital, rehabilitation, or nursing home days saved based on their diagnosis and projected length of treatment. Results Twenty-eight patients (24 inpatient, 4 outpatient) were included in the study. The majority were uninsured (89%), homeless (64%), or had active intravenous drug use (IDU) (60%). Indications for use included SSTI (42.9%), bacteremia (64.3%), and OM (42.6%). Clinical failure was observed in 4 (14%), 1 (3.5%), and 2 (7.1%) patients at 30, 60, or 90 days (respectively). Nonadherence to medical recommendations, lack of source control, and ongoing IDU increased risk of returning to the hospital. Dalbavancin use saved a total of 381 days of inpatient/rehab/facility stay. Baseline Characteristics of Patients Types of Infections and Microbiology ED Visit or Readmissions at 30, 60, or 90 Days Conclusion Dalbavancin showed similar rates of success with improved length of stay and cost savings. The use of long acting lipoglycopeptides are desirable alternatives to traditional OPAT for patients that otherwise would not qualify for OPAT or desire less hospital contact. Disclosures All Authors: No reported disclosures

scholarly journals Validation of LRINEC (Laboratory Risk Indicators for Diagnosis of Necrotizing Fasciitis) Scoring System for the Diagnosis of Necrotizing Fasciitis

2020 ◽  
Vol 23 (2) ◽  
pp. 75-80
Author(s):  
Md Nur Alam Mohim ◽  
MA Hashem Bhuiya ◽  
AZM Mahfuzur Rahman ◽  
Md Mahmudul Islam ◽  
Masfique Ahmed Bhuiya
Keyword(s):  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Early Recognition ◽  
Subcutaneous Tissue ◽  
Risk Indicators ◽  
Soft Tissue Infections ◽  
Predictive Values ◽  
Lrinec Score ◽  
Surgery Department ◽  
Severe Soft Tissue

Background : Necrotizing fasciitis (NF) is a rare but potentially fatal infection involving the subcutaneous tissue and fascia. Different classifications and terminology has been used in NF based on affected anatomy, microbial cause and depth of infection. Clinical scores like the laboratory risk indicators for NF (LRINEC) scores are available to help diagnose NF and differentiate it from other skin and soft tissue infections. Methods : A total of 100 patients were included in the study between January 2014 to June 2014. This prospective study was done on patients admitted in surgery department of DMCH with symptoms suggestive of soft tissue infections during the study period. Results : Mean age was found 46.5(±13.8) years in severe cellulitis and 50.9(±9.8) years in necroting fasciitis (p>0.05). Male were predominant (60%). 80% of NF had DM. The validation test for LRINEC score e”6 vs necrotizing fasciitis had sensitivity of 66%, specificity 84%, accuracy 75%, positive and negative predictive values were 80.49% and 71.19% respectively. Mortality of NF was 6%. Conclusion : The LRINEC score is an impressive diagnostic tool to distinguish necrotizing fasciitis from other severe soft tissue infections, but it is not useful for early recognition of necrotizing fasciitis. Journal of Surgical Sciences (2019) Vol. 23(2): 75-80

The Cost of Health Care — Highlights from a Discussion about Economics and Reform

2009 ◽  
Vol 361 (15) ◽  
pp. 1421-1423 ◽  
Author(s):  
Atul A. Gawande ◽  
Elliott S. Fisher ◽  
Jonathan Gruber ◽  
Meredith B. Rosenthal
Keyword(s):  
Health Care ◽  
Cost Of Health Care ◽  
The Cost

Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 13-14
Author(s):  
Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽  
Maryam Al Ali, MBBS
Keyword(s):  
Emergency Department ◽  
Critical Care ◽  
Case Report ◽  
Soft Tissue ◽  
Necrotizing Fasciitis ◽  
Soft Tissue Infection ◽  
Critical Care Unit ◽  
Point Of Care ◽  
Point Of Care Ultrasound ◽  
Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

Sign in / Sign up

Export Citation Format

Share Document