Skip to main content
Top
Published in: Intensive Care Medicine 12/2016

01-12-2016 | Review

Diagnosis and management of skin and soft tissue infections in the intensive care unit: a review

Authors: Jason P. Burnham, John P. Kirby, Marin H. Kollef

Published in: Intensive Care Medicine | Issue 12/2016

Login to get access

Abstract

Purpose

To review the salient features of the diagnosis and management of the most common skin and soft tissue infections (SSTI). This review focuses on severe SSTIs that require care in an intensive care unit (ICU), including toxic shock syndrome, myonecrosis/gas gangrene, and necrotizing fasciitis.

Methods

Guidelines, expert opinion, and local institutional policies were reviewed.

Results

Severe SSTIs are common and their management complex due to regional variation in predominant pathogens and antimicrobial resistance patterns, as well as variations in host immune responses. Unique aspects of care for SSTIs in the ICU are discussed, including the role of prosthetic devices, risk factors for bacteremia, and the need for surgical consultation. SSTI mimetics, the role of dermatologic consultation, and the unique features of SSTIs in immunocompromised hosts are also described.

Conclusions

We provide recommendations for clinicians regarding optimal SSTI management in the ICU setting.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hersh AL, Chambers HF, Maselli JH, Gonzales R (2008) National trends in ambulatory visits and antibiotic prescribing for skin and soft-tissue infections. Arch Intern Med 168:1585–1591CrossRefPubMed Hersh AL, Chambers HF, Maselli JH, Gonzales R (2008) National trends in ambulatory visits and antibiotic prescribing for skin and soft-tissue infections. Arch Intern Med 168:1585–1591CrossRefPubMed
2.
go back to reference Edelsberg J, Taneja C, Zervos M, Haque N, Moore C, Reyes K, Spalding J, Jiang J, Oster G (2009) Trends in US hospital admissions for skin and soft tissue infections. Emerg Infect Dis 15:1516–1518CrossRefPubMedPubMedCentral Edelsberg J, Taneja C, Zervos M, Haque N, Moore C, Reyes K, Spalding J, Jiang J, Oster G (2009) Trends in US hospital admissions for skin and soft tissue infections. Emerg Infect Dis 15:1516–1518CrossRefPubMedPubMedCentral
3.
go back to reference Moet GJ, Jones RN, Biedenbach DJ, Stilwell MG, Fritsche TR (2007) Contemporary causes of skin and soft tissue infections in North America, Latin America, and Europe: report from the SENTRY Antimicrobial Surveillance Program (1998–2004). Diagn Microbiol Infect Dis 57:7–13CrossRefPubMed Moet GJ, Jones RN, Biedenbach DJ, Stilwell MG, Fritsche TR (2007) Contemporary causes of skin and soft tissue infections in North America, Latin America, and Europe: report from the SENTRY Antimicrobial Surveillance Program (1998–2004). Diagn Microbiol Infect Dis 57:7–13CrossRefPubMed
4.
go back to reference European Centre for Disease Prevention and Control (2013) Annual Epidemiological Report 2012. Reporting on 2010 surveillance data and 2011 epidemic intelligence data. ECDC, Stockholm European Centre for Disease Prevention and Control (2013) Annual Epidemiological Report 2012. Reporting on 2010 surveillance data and 2011 epidemic intelligence data. ECDC, Stockholm
5.
go back to reference Itani KMF, Sorensen S, Stokes M, Shelbaya A, McKinnon P (2009) A regional comparison of resource utilization in patients with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections (CSSTI) treated with linezolid vs vancomycin. In: [Presentation O-1791] 49th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), San Francisco Itani KMF, Sorensen S, Stokes M, Shelbaya A, McKinnon P (2009) A regional comparison of resource utilization in patients with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections (CSSTI) treated with linezolid vs vancomycin. In: [Presentation O-1791] 49th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC), San Francisco
6.
go back to reference Mullins CD, Yang K, Onukwugha E, Eisenberg DF, Myers DE, Huang DB, Lodise T (2013) Rehospitalizations and direct medical costs for cSSSI: linezolid versus vancomycin. Am J Pharm Benefits 5:258–267 Mullins CD, Yang K, Onukwugha E, Eisenberg DF, Myers DE, Huang DB, Lodise T (2013) Rehospitalizations and direct medical costs for cSSSI: linezolid versus vancomycin. Am J Pharm Benefits 5:258–267
7.
go back to reference Garau J, Ostermann H, Medina J, Avila M, McBride K, Blasi F (2013) Current management of patients hospitalized with complicated skin and soft tissue infections across Europe (2010–2011): assessment of clinical practice patterns and real-life effectiveness of antibiotics from the REACH study. Clin Microbiol Infect 19:E377–E385CrossRefPubMed Garau J, Ostermann H, Medina J, Avila M, McBride K, Blasi F (2013) Current management of patients hospitalized with complicated skin and soft tissue infections across Europe (2010–2011): assessment of clinical practice patterns and real-life effectiveness of antibiotics from the REACH study. Clin Microbiol Infect 19:E377–E385CrossRefPubMed
8.
go back to reference Crisp JG, Takhar SS, Moran GJ, Krishnadasan A, Dowd SE, Finegold SM, Summanen PH, Talan DA (2015) Inability of polymerase chain reaction, pyrosequencing, and culture of infected and uninfected site skin biopsy specimens to identify the cause of cellulitis. Clin Infect Dis 61:1679–1687PubMed Crisp JG, Takhar SS, Moran GJ, Krishnadasan A, Dowd SE, Finegold SM, Summanen PH, Talan DA (2015) Inability of polymerase chain reaction, pyrosequencing, and culture of infected and uninfected site skin biopsy specimens to identify the cause of cellulitis. Clin Infect Dis 61:1679–1687PubMed
9.
go back to reference Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan SL, Montoya JG, Wade JC (2014) Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 59:e10–e52CrossRefPubMed Stevens DL, Bisno AL, Chambers HF, Dellinger EP, Goldstein EJ, Gorbach SL, Hirschmann JV, Kaplan SL, Montoya JG, Wade JC (2014) Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 59:e10–e52CrossRefPubMed
10.
go back to reference Stevens DL (2015) Reply to Gonzalez del Castillo et al and Rashid and Kravitz. Clin Infect Dis 60:172–174CrossRefPubMed Stevens DL (2015) Reply to Gonzalez del Castillo et al and Rashid and Kravitz. Clin Infect Dis 60:172–174CrossRefPubMed
11.
go back to reference Tischendorf J, de Avila RA, Safdar N (2016) Risk of infection following colonization with carbapenem-resistant Enterobactericeae: a systematic review. Am J Infect Control 44:539–543CrossRefPubMed Tischendorf J, de Avila RA, Safdar N (2016) Risk of infection following colonization with carbapenem-resistant Enterobactericeae: a systematic review. Am J Infect Control 44:539–543CrossRefPubMed
12.
go back to reference Bolognia JL, Jorizzo J, Schaffer JV (2012) Dermatology. Elsevier Saunders, Philadelphia Bolognia JL, Jorizzo J, Schaffer JV (2012) Dermatology. Elsevier Saunders, Philadelphia
13.
go back to reference Reich HL, Fadeyi DW, Naik NS, Honig PJ, Yan AC (2004) Nonpseudomonal ecthyma gangrenosum. J Am Acad Dermatol 50:S114–S117CrossRefPubMed Reich HL, Fadeyi DW, Naik NS, Honig PJ, Yan AC (2004) Nonpseudomonal ecthyma gangrenosum. J Am Acad Dermatol 50:S114–S117CrossRefPubMed
14.
go back to reference Vaiman M, Lazarovitch T, Heller L, Lotan G (2015) Ecthyma gangrenosum and ecthyma-like lesions: review article. Eur J Clin Microbiol Infect Dis 34:633–639CrossRefPubMed Vaiman M, Lazarovitch T, Heller L, Lotan G (2015) Ecthyma gangrenosum and ecthyma-like lesions: review article. Eur J Clin Microbiol Infect Dis 34:633–639CrossRefPubMed
15.
go back to reference Jeng A, Beheshti M, Li J, Nathan R (2010) The role of beta-hemolytic streptococci in causing diffuse, nonculturable cellulitis: a prospective investigation. Medicine 89:217–226CrossRefPubMed Jeng A, Beheshti M, Li J, Nathan R (2010) The role of beta-hemolytic streptococci in causing diffuse, nonculturable cellulitis: a prospective investigation. Medicine 89:217–226CrossRefPubMed
16.
go back to reference Garcia C, Hallin M, Deplano A, Denis O, Sihuincha M, de Groot R, Gotuzzo E, Jacobs J (2013) Staphylococcus aureus causing tropical pyomyositis, Amazon Basin, Peru. Emerg Infect Dis 19:123–125CrossRefPubMedPubMedCentral Garcia C, Hallin M, Deplano A, Denis O, Sihuincha M, de Groot R, Gotuzzo E, Jacobs J (2013) Staphylococcus aureus causing tropical pyomyositis, Amazon Basin, Peru. Emerg Infect Dis 19:123–125CrossRefPubMedPubMedCentral
17.
go back to reference Theodorou SJ, Theodorou DJ, Resnick D (2007) MR imaging findings of pyogenic bacterial myositis (pyomyositis) in patients with local muscle trauma: illustrative cases. Emerg Radiol 14:89–96CrossRefPubMed Theodorou SJ, Theodorou DJ, Resnick D (2007) MR imaging findings of pyogenic bacterial myositis (pyomyositis) in patients with local muscle trauma: illustrative cases. Emerg Radiol 14:89–96CrossRefPubMed
18.
go back to reference Kumar MP, Seif D, Perera P, Mailhot T (2014) Point-of-care ultrasound in diagnosing pyomyositis: a report of three cases. J Emerg Med 47:420–426CrossRefPubMed Kumar MP, Seif D, Perera P, Mailhot T (2014) Point-of-care ultrasound in diagnosing pyomyositis: a report of three cases. J Emerg Med 47:420–426CrossRefPubMed
19.
go back to reference Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, Hebert L, Newhouse JP, Weiler PC, Hiatt H (1991) The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med 324:377–384CrossRefPubMed Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, Hebert L, Newhouse JP, Weiler PC, Hiatt H (1991) The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med 324:377–384CrossRefPubMed
20.
go back to reference Mangram AJ, Horan TC, Pearson ML, Pearson ML, Silver LC, Jarvis WR (1999) Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 20:250–278 (quiz 279–280) CrossRefPubMed Mangram AJ, Horan TC, Pearson ML, Pearson ML, Silver LC, Jarvis WR (1999) Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 20:250–278 (quiz 279–280) CrossRefPubMed
21.
go back to reference Wilson J, Ramboer I, Suetens C (2007) Hospitals in Europe Link for Infection Control through Surveillance (HELICS). Inter-country comparison of rates of surgical site infection–opportunities and limitations. J Hosp Infect 65(Suppl 2):165–170CrossRefPubMed Wilson J, Ramboer I, Suetens C (2007) Hospitals in Europe Link for Infection Control through Surveillance (HELICS). Inter-country comparison of rates of surgical site infection–opportunities and limitations. J Hosp Infect 65(Suppl 2):165–170CrossRefPubMed
22.
go back to reference Winfield RD, Reese S, Bochicchio K, Mazuski JE, Bochicchio GV (2016) Obesity and the risk for surgical site infection in abdominal surgery. Am Surg 82:331–336PubMed Winfield RD, Reese S, Bochicchio K, Mazuski JE, Bochicchio GV (2016) Obesity and the risk for surgical site infection in abdominal surgery. Am Surg 82:331–336PubMed
23.
go back to reference Pedroso-Fernandez Y, Aguirre-Jaime A, Ramos MJ, Hernandez M, Cuervo M, Bravo A, Carrillo A (2016) Prediction of surgical site infection after colorectal surgery. Am J Infect Control 44:450–454CrossRefPubMed Pedroso-Fernandez Y, Aguirre-Jaime A, Ramos MJ, Hernandez M, Cuervo M, Bravo A, Carrillo A (2016) Prediction of surgical site infection after colorectal surgery. Am J Infect Control 44:450–454CrossRefPubMed
24.
go back to reference Olsen MA, Nickel KB, Margenthaler JA, Fox IK, Ball KE, Mines D, Wallace AE, Colditz GA, Fraser VJ (2016) Development of a risk prediction model to individualize risk factors for surgical site infection after mastectomy. Ann Surg Oncol 23:2471–2479CrossRefPubMed Olsen MA, Nickel KB, Margenthaler JA, Fox IK, Ball KE, Mines D, Wallace AE, Colditz GA, Fraser VJ (2016) Development of a risk prediction model to individualize risk factors for surgical site infection after mastectomy. Ann Surg Oncol 23:2471–2479CrossRefPubMed
25.
go back to reference European Centre for Disease Prevention and Control (2013) Surveillance of surgical site infections in Europe 2010–2011. ECDC, Stockholm European Centre for Disease Prevention and Control (2013) Surveillance of surgical site infections in Europe 2010–2011. ECDC, Stockholm
26.
go back to reference Lipsky BA, Kollef MH, Miller LG, Sun X, Johannes RS, Tabak YP (2010) Predicting bacteremia among patients hospitalized for skin and skin-structure infections: derivation and validation of a risk score. Infect Control Hosp Epidemiol 31:828–837CrossRefPubMed Lipsky BA, Kollef MH, Miller LG, Sun X, Johannes RS, Tabak YP (2010) Predicting bacteremia among patients hospitalized for skin and skin-structure infections: derivation and validation of a risk score. Infect Control Hosp Epidemiol 31:828–837CrossRefPubMed
27.
28.
go back to reference Cohen AL, Bhatnagar J, Reagan S, Zane SB, D’Angeli MA, Fischer M, Killgore G, Kwan-Gett TS, Blossom DB, Shieh WJ, Guarner J, Jernigan J, Duchin JS, Zaki SR, McDonald LC (2007) Toxic shock associated with Clostridium sordellii and Clostridium perfringens after medical and spontaneous abortion. Obstet Gynecol 110:1027–1033CrossRefPubMed Cohen AL, Bhatnagar J, Reagan S, Zane SB, D’Angeli MA, Fischer M, Killgore G, Kwan-Gett TS, Blossom DB, Shieh WJ, Guarner J, Jernigan J, Duchin JS, Zaki SR, McDonald LC (2007) Toxic shock associated with Clostridium sordellii and Clostridium perfringens after medical and spontaneous abortion. Obstet Gynecol 110:1027–1033CrossRefPubMed
29.
go back to reference Fischer M, Bhatnagar J, Guarner J, Reagan S, Hacker JK, Van Meter SH, Poukens V, Whiteman DB, Iton A, Cheung M, Dassey DE, Shieh WJ, Zaki SR (2005) Fatal toxic shock syndrome associated with Clostridium sordellii after medical abortion. N Engl J Med 353:2352–2360CrossRefPubMed Fischer M, Bhatnagar J, Guarner J, Reagan S, Hacker JK, Van Meter SH, Poukens V, Whiteman DB, Iton A, Cheung M, Dassey DE, Shieh WJ, Zaki SR (2005) Fatal toxic shock syndrome associated with Clostridium sordellii after medical abortion. N Engl J Med 353:2352–2360CrossRefPubMed
30.
go back to reference Stevens DL, Wallace RJ, Hamilton SM, Bryant AE (2006) Successful treatment of staphylococcal toxic shock syndrome with linezolid: a case report and in vitro evaluation of the production of toxic shock syndrome toxin type 1 in the presence of antibiotics. Clin Infect Dis 42:729–730CrossRefPubMed Stevens DL, Wallace RJ, Hamilton SM, Bryant AE (2006) Successful treatment of staphylococcal toxic shock syndrome with linezolid: a case report and in vitro evaluation of the production of toxic shock syndrome toxin type 1 in the presence of antibiotics. Clin Infect Dis 42:729–730CrossRefPubMed
31.
go back to reference Carapetis JR, Jacoby P, Carville K, Ang SJ, Curtis N, Andrews R (2014) Effectiveness of clindamycin and intravenous immunoglobulin, and risk of disease in contacts, in invasive group a streptococcal infections. Clin Infect Dis 59:358–365CrossRefPubMed Carapetis JR, Jacoby P, Carville K, Ang SJ, Curtis N, Andrews R (2014) Effectiveness of clindamycin and intravenous immunoglobulin, and risk of disease in contacts, in invasive group a streptococcal infections. Clin Infect Dis 59:358–365CrossRefPubMed
32.
go back to reference Stevens DL, Ma Y, Salmi DB, McIndoo E, Wallace RJ, Bryant AE (2007) Impact of antibiotics on expression of virulence-associated exotoxin genes in methicillin-sensitive and methicillin-resistant Staphylococcus aureus. J Infect Dis 195:202–211CrossRefPubMed Stevens DL, Ma Y, Salmi DB, McIndoo E, Wallace RJ, Bryant AE (2007) Impact of antibiotics on expression of virulence-associated exotoxin genes in methicillin-sensitive and methicillin-resistant Staphylococcus aureus. J Infect Dis 195:202–211CrossRefPubMed
33.
go back to reference Coyle EA, Cha R, Rybak MJ (2003) Influences of linezolid, penicillin, and clindamycin, alone and in combination, on streptococcal pyrogenic exotoxin a release. Antimicrob Agents Chemother 47:1752–1755CrossRefPubMedPubMedCentral Coyle EA, Cha R, Rybak MJ (2003) Influences of linezolid, penicillin, and clindamycin, alone and in combination, on streptococcal pyrogenic exotoxin a release. Antimicrob Agents Chemother 47:1752–1755CrossRefPubMedPubMedCentral
34.
go back to reference Darenberg J, Ihendyane N, Sjolin J, Aufwerber E, Haidl S, Follin P, Andersson J, Norrby-Teglund A (2003) Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: a European randomized, double-blind, placebo-controlled trial. Clin Infect Dis 37:333–340CrossRefPubMed Darenberg J, Ihendyane N, Sjolin J, Aufwerber E, Haidl S, Follin P, Andersson J, Norrby-Teglund A (2003) Intravenous immunoglobulin G therapy in streptococcal toxic shock syndrome: a European randomized, double-blind, placebo-controlled trial. Clin Infect Dis 37:333–340CrossRefPubMed
35.
go back to reference Linner A, Darenberg J, Sjolin J, Henriques-Normark B, Norrby-Teglund A (2014) Clinical efficacy of polyspecific intravenous immunoglobulin therapy in patients with streptococcal toxic shock syndrome: a comparative observational study. Clin Infect Dis 59:851–857CrossRefPubMed Linner A, Darenberg J, Sjolin J, Henriques-Normark B, Norrby-Teglund A (2014) Clinical efficacy of polyspecific intravenous immunoglobulin therapy in patients with streptococcal toxic shock syndrome: a comparative observational study. Clin Infect Dis 59:851–857CrossRefPubMed
36.
go back to reference Matsushima A, Kuroki Y, Nakajima S, Sakai T, Kojima H, Ueyama M (2015) Low level of TSST-1 antibody in burn patients with toxic shock syndrome caused by methicillin-resistant Staphylococcus aureus. J Burn Care Res 36:e120–e124CrossRefPubMed Matsushima A, Kuroki Y, Nakajima S, Sakai T, Kojima H, Ueyama M (2015) Low level of TSST-1 antibody in burn patients with toxic shock syndrome caused by methicillin-resistant Staphylococcus aureus. J Burn Care Res 36:e120–e124CrossRefPubMed
37.
go back to reference Umbert IJ, Winkelmann RK, Oliver GF, Peters MS (1989) Necrotizing fasciitis: a clinical, microbiologic, and histopathologic study of 14 patients. J Am Acad Dermatol 20:774–781CrossRefPubMed Umbert IJ, Winkelmann RK, Oliver GF, Peters MS (1989) Necrotizing fasciitis: a clinical, microbiologic, and histopathologic study of 14 patients. J Am Acad Dermatol 20:774–781CrossRefPubMed
38.
go back to reference Bangsberg DR, Rosen JI, Aragon T, Campbell A, Weir L, Perdreau-Remington F (2002) Clostridial myonecrosis cluster among injection drug users: a molecular epidemiology investigation. Arch Intern Med 162:517–522CrossRefPubMed Bangsberg DR, Rosen JI, Aragon T, Campbell A, Weir L, Perdreau-Remington F (2002) Clostridial myonecrosis cluster among injection drug users: a molecular epidemiology investigation. Arch Intern Med 162:517–522CrossRefPubMed
39.
go back to reference Ahmed S, Gruer L, McGuigan C, Penrice G, Roberts K, Hood J, Redding P, Edwards G, Black M, McFarlane J, Cromie D, Howie H, Leonard A, Goldberg D, Taylor A, Hutchinson S, Roy K, Wadd S, Andraghetti R, Barry J, Sayers G, Cronin M, O'Connell T, Ward M, O'Sullivan P, O'Herlihy B, Keenan E, O'Connor J, Mullen L, Sweeney B, O'Flanagan D, Igoe D, Bergin C, O'Briain S, Keane C, Mulvihill E, Plunkett P, McMahon G, Boyle T, Clarke S, Leen E, Cassidy M, Djuretic T, Gill N, Hope V, Jones J, Nichols G, Weild A, George R, Borriello P, Brazier J, Salmon J, Lightfoot N, Roberts A (2000) Update: Clostridium novyi and unexplained illness among injecting-drug users-Scotland, Ireland, and England, April–June 2000. MMWR Morb Mortal Wkly Rep 49:543–545 Ahmed S, Gruer L, McGuigan C, Penrice G, Roberts K, Hood J, Redding P, Edwards G, Black M, McFarlane J, Cromie D, Howie H, Leonard A, Goldberg D, Taylor A, Hutchinson S, Roy K, Wadd S, Andraghetti R, Barry J, Sayers G, Cronin M, O'Connell T, Ward M, O'Sullivan P, O'Herlihy B, Keenan E, O'Connor J, Mullen L, Sweeney B, O'Flanagan D, Igoe D, Bergin C, O'Briain S, Keane C, Mulvihill E, Plunkett P, McMahon G, Boyle T, Clarke S, Leen E, Cassidy M, Djuretic T, Gill N, Hope V, Jones J, Nichols G, Weild A, George R, Borriello P, Brazier J, Salmon J, Lightfoot N, Roberts A (2000) Update: Clostridium novyi and unexplained illness among injecting-drug users-Scotland, Ireland, and England, April–June 2000. MMWR Morb Mortal Wkly Rep 49:543–545
40.
go back to reference Kimura AC, Higa JI, Levin RM, Simpson G, Vargas Y, Vugia DJ (2004) Outbreak of necrotizing fasciitis due to Clostridium sordellii among black-tar heroin users. Clin Infect Dis 38:e87–e91CrossRefPubMed Kimura AC, Higa JI, Levin RM, Simpson G, Vargas Y, Vugia DJ (2004) Outbreak of necrotizing fasciitis due to Clostridium sordellii among black-tar heroin users. Clin Infect Dis 38:e87–e91CrossRefPubMed
41.
go back to reference Aldape MJ, Bryant AE, Stevens DL (2006) Clostridium sordellii infection: epidemiology, clinical findings, and current perspectives on diagnosis and treatment. Clin Infect Dis 43:1436–1446CrossRefPubMed Aldape MJ, Bryant AE, Stevens DL (2006) Clostridium sordellii infection: epidemiology, clinical findings, and current perspectives on diagnosis and treatment. Clin Infect Dis 43:1436–1446CrossRefPubMed
42.
go back to reference Sinave C, Le Templier G, Blouin D, Leveille F, Deland E (2002) Toxic shock syndrome due to Clostridium sordellii: a dramatic postpartum and postabortion disease. Clin Infect Dis 35:1441–1443CrossRefPubMed Sinave C, Le Templier G, Blouin D, Leveille F, Deland E (2002) Toxic shock syndrome due to Clostridium sordellii: a dramatic postpartum and postabortion disease. Clin Infect Dis 35:1441–1443CrossRefPubMed
43.
go back to reference Ellis Simonsen SM, van Orman ER, Hatch BE, Jones SS, Gren LH, Hegmann KT, Lyon JL (2006) Cellulitis incidence in a defined population. Epidemiol Infect 134:293–299CrossRefPubMed Ellis Simonsen SM, van Orman ER, Hatch BE, Jones SS, Gren LH, Hegmann KT, Lyon JL (2006) Cellulitis incidence in a defined population. Epidemiol Infect 134:293–299CrossRefPubMed
44.
go back to reference Das DK, Baker MG, Venugopal K (2011) Increasing incidence of necrotizing fasciitis in New Zealand: a nationwide study over the period 1990–2006. J Infect 63:429–433CrossRefPubMed Das DK, Baker MG, Venugopal K (2011) Increasing incidence of necrotizing fasciitis in New Zealand: a nationwide study over the period 1990–2006. J Infect 63:429–433CrossRefPubMed
45.
go back to reference Shaked H, Samra Z, Paul M, Madar-Shapiro L, Cohen J, Pitlik S, Bishara J (2012) Unusual “flesh-eating” strains of Escherichia coli. J Clin Microbiol 50:4008–4011CrossRefPubMedPubMedCentral Shaked H, Samra Z, Paul M, Madar-Shapiro L, Cohen J, Pitlik S, Bishara J (2012) Unusual “flesh-eating” strains of Escherichia coli. J Clin Microbiol 50:4008–4011CrossRefPubMedPubMedCentral
46.
go back to reference Cheng NC, Yu YC, Tai HC, Hsueh PR, Chang SC, Lai SY, Yi WC, Fang CT (2012) Recent trend of necrotizing fasciitis in Taiwan: focus on monomicrobial Klebsiella pneumoniae necrotizing fasciitis. Clin Infect Dis 55:930–939CrossRefPubMed Cheng NC, Yu YC, Tai HC, Hsueh PR, Chang SC, Lai SY, Yi WC, Fang CT (2012) Recent trend of necrotizing fasciitis in Taiwan: focus on monomicrobial Klebsiella pneumoniae necrotizing fasciitis. Clin Infect Dis 55:930–939CrossRefPubMed
47.
go back to reference Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO (2003) Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 85-a:1454–1460CrossRefPubMed Wong CH, Chang HC, Pasupathy S, Khin LW, Tan JL, Low CO (2003) Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality. J Bone Joint Surg Am 85-a:1454–1460CrossRefPubMed
48.
go back to reference Kim KT, Kim YJ, Won Lee J, Kim YJ, Park SW, Lim MK, Suh CH (2011) Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging? Radiology 259:816–824CrossRefPubMed Kim KT, Kim YJ, Won Lee J, Kim YJ, Park SW, Lim MK, Suh CH (2011) Can necrotizing infectious fasciitis be differentiated from nonnecrotizing infectious fasciitis with MR imaging? Radiology 259:816–824CrossRefPubMed
49.
go back to reference El-Gazzaz GH, Farag SH, El-Sayd MA, Mohamed HH (2012) The use of synthetic mesh in patients undergoing ventral hernia repair during colorectal resection: risk of infection and recurrence. Asian J Surg 35:149–153CrossRefPubMed El-Gazzaz GH, Farag SH, El-Sayd MA, Mohamed HH (2012) The use of synthetic mesh in patients undergoing ventral hernia repair during colorectal resection: risk of infection and recurrence. Asian J Surg 35:149–153CrossRefPubMed
50.
go back to reference Nienaber JJ, Kusne S, Riaz T, Walker RC, Baddour LM, Wright AJ, Park SJ, Vikram HR, Keating MR, Arabia FA, Lahr BD, Sohail MR (2013) Clinical manifestations and management of left ventricular assist device-associated infections. Clin Infect Dis 57:1438–1448CrossRefPubMedPubMedCentral Nienaber JJ, Kusne S, Riaz T, Walker RC, Baddour LM, Wright AJ, Park SJ, Vikram HR, Keating MR, Arabia FA, Lahr BD, Sohail MR (2013) Clinical manifestations and management of left ventricular assist device-associated infections. Clin Infect Dis 57:1438–1448CrossRefPubMedPubMedCentral
51.
go back to reference Baddour LM, Epstein AE, Erickson CC, Knight BP, Levison ME, Lockhart PB, Masoudi FA, Okum EJ, Wilson WR, Beerman LB, Bolger AF, Estes NA 3rd, Gewitz M, Newburger JW, Schron EB, Taubert KA (2010) Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association. Circulation 121:458–477CrossRefPubMed Baddour LM, Epstein AE, Erickson CC, Knight BP, Levison ME, Lockhart PB, Masoudi FA, Okum EJ, Wilson WR, Beerman LB, Bolger AF, Estes NA 3rd, Gewitz M, Newburger JW, Schron EB, Taubert KA (2010) Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association. Circulation 121:458–477CrossRefPubMed
52.
go back to reference Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, Raad II, Rijnders BJ, Sherertz RJ, Warren DK (2009) Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 49:1–45CrossRefPubMedPubMedCentral Mermel LA, Allon M, Bouza E, Craven DE, Flynn P, O’Grady NP, Raad II, Rijnders BJ, Sherertz RJ, Warren DK (2009) Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 Update by the Infectious Diseases Society of America. Clin Infect Dis 49:1–45CrossRefPubMedPubMedCentral
53.
go back to reference Strazzula L, Cotliar J, Fox LP, Hughey L, Shinkai K, Gee SN, Kroshinsky D (2015) Inpatient dermatology consultation aids diagnosis of cellulitis among hospitalized patients: a multi-institutional analysis. J Am Acad Dermatol 73:70–75CrossRefPubMed Strazzula L, Cotliar J, Fox LP, Hughey L, Shinkai K, Gee SN, Kroshinsky D (2015) Inpatient dermatology consultation aids diagnosis of cellulitis among hospitalized patients: a multi-institutional analysis. J Am Acad Dermatol 73:70–75CrossRefPubMed
54.
go back to reference Arakaki RY, Strazzula L, Woo E, Kroshinsky D (2014) The impact of dermatology consultation on diagnostic accuracy and antibiotic use among patients with suspected cellulitis seen at outpatient internal medicine offices: a randomized clinical trial. JAMA Dermatol 150:1056–1061CrossRefPubMed Arakaki RY, Strazzula L, Woo E, Kroshinsky D (2014) The impact of dermatology consultation on diagnostic accuracy and antibiotic use among patients with suspected cellulitis seen at outpatient internal medicine offices: a randomized clinical trial. JAMA Dermatol 150:1056–1061CrossRefPubMed
55.
go back to reference Falagas ME, Vergidis PI (2005) Narrative review: diseases that masquerade as infectious cellulitis. Ann Intern Med 142:47–55CrossRefPubMed Falagas ME, Vergidis PI (2005) Narrative review: diseases that masquerade as infectious cellulitis. Ann Intern Med 142:47–55CrossRefPubMed
56.
go back to reference Agrawal P, Peter JV, George R (2013) Dermatological manifestations and relationship to outcomes of patients admitted to a medical intensive care unit: a study from a tertiary care hospital in India. Postgrad Med J 89:501–507CrossRefPubMed Agrawal P, Peter JV, George R (2013) Dermatological manifestations and relationship to outcomes of patients admitted to a medical intensive care unit: a study from a tertiary care hospital in India. Postgrad Med J 89:501–507CrossRefPubMed
57.
go back to reference George SM, Harrison DA, Welch CA, Nolan KM, Friedmann PS (2008) Dermatological conditions in intensive care: a secondary analysis of the Intensive Care National Audit and Research Centre (ICNARC) Case Mix Programme database. Crit Care 12(Suppl 1):S1CrossRefPubMedPubMedCentral George SM, Harrison DA, Welch CA, Nolan KM, Friedmann PS (2008) Dermatological conditions in intensive care: a secondary analysis of the Intensive Care National Audit and Research Centre (ICNARC) Case Mix Programme database. Crit Care 12(Suppl 1):S1CrossRefPubMedPubMedCentral
58.
go back to reference Emre S, Emre C, Akoglu G, Demirseren DD, Metin A (2013) Evaluation of dermatological consultations of patients treated in intensive care unit. Dermatology 226:75–80CrossRefPubMed Emre S, Emre C, Akoglu G, Demirseren DD, Metin A (2013) Evaluation of dermatological consultations of patients treated in intensive care unit. Dermatology 226:75–80CrossRefPubMed
59.
go back to reference Badia M, Servia L, Casanova JM, Montserrat N, Vilanova J, Vicario E, Rodriguez A, Trujillano J (2013) Classification of dermatological disorders in critical care patients: a prospective observational study. J Crit Care 28:220 (e221–228) CrossRefPubMed Badia M, Servia L, Casanova JM, Montserrat N, Vilanova J, Vicario E, Rodriguez A, Trujillano J (2013) Classification of dermatological disorders in critical care patients: a prospective observational study. J Crit Care 28:220 (e221–228) CrossRefPubMed
60.
go back to reference de Prost N, Sbidian E, Chosidow O, Brun-Buisson C, Amathieu R (2015) Management of necrotizing soft tissue infections in the intensive care unit: results of an international survey. Intensive Care Med 41:1506–1508CrossRefPubMed de Prost N, Sbidian E, Chosidow O, Brun-Buisson C, Amathieu R (2015) Management of necrotizing soft tissue infections in the intensive care unit: results of an international survey. Intensive Care Med 41:1506–1508CrossRefPubMed
61.
go back to reference de Geus HR, van der Klooster JM (2005) Vacuum-assisted closure in the treatment of large skin defects due to necrotizing fasciitis. Intensive Care Med 31:601CrossRefPubMed de Geus HR, van der Klooster JM (2005) Vacuum-assisted closure in the treatment of large skin defects due to necrotizing fasciitis. Intensive Care Med 31:601CrossRefPubMed
62.
go back to reference Chen IW, Yang HM, Chiu CH, Yeh JT, Huang CH, Huang YY (2015) Clinical characteristics and risk factor analysis for lower-extremity amputations in diabetic patients with foot ulcer complicated by necrotizing fasciitis. Medicine 94:e1957CrossRefPubMedPubMedCentral Chen IW, Yang HM, Chiu CH, Yeh JT, Huang CH, Huang YY (2015) Clinical characteristics and risk factor analysis for lower-extremity amputations in diabetic patients with foot ulcer complicated by necrotizing fasciitis. Medicine 94:e1957CrossRefPubMedPubMedCentral
63.
go back to reference Pham TN, Moore ML, Costa BA, Cuschieri J, Klein MB (2009) Assessment of functional limitation after necrotizing soft tissue infection. J Burn Care Res 30:301–306CrossRefPubMedPubMedCentral Pham TN, Moore ML, Costa BA, Cuschieri J, Klein MB (2009) Assessment of functional limitation after necrotizing soft tissue infection. J Burn Care Res 30:301–306CrossRefPubMedPubMedCentral
64.
go back to reference Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC (2016) The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA 315:801–810CrossRefPubMedPubMedCentral Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, Bellomo R, Bernard GR, Chiche JD, Coopersmith CM, Hotchkiss RS, Levy MM, Marshall JC, Martin GS, Opal SM, Rubenfeld GD, van der Poll T, Vincent JL, Angus DC (2016) The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA 315:801–810CrossRefPubMedPubMedCentral
65.
go back to reference European Centre for Disease Prevention and Control (2016) Proportion of methicillin resistant Staphylococcus aureus (MRSA) isolates in participating countries in 2014. ECDC, Stockholm. Accessed 19 July 2016 European Centre for Disease Prevention and Control (2016) Proportion of methicillin resistant Staphylococcus aureus (MRSA) isolates in participating countries in 2014. ECDC, Stockholm. Accessed 19 July 2016
66.
go back to reference Zilberberg M, Micek ST, Kollef MH, Shelbaya A, Shorr AF (2012) Risk factors for mixed complicated skin and skin structure infections to help tailor appropriate empiric therapy. Surg Infect 13:377–382CrossRef Zilberberg M, Micek ST, Kollef MH, Shelbaya A, Shorr AF (2012) Risk factors for mixed complicated skin and skin structure infections to help tailor appropriate empiric therapy. Surg Infect 13:377–382CrossRef
67.
go back to reference Eells SJ, Nguyen M, Jung J, Macias-Gil R, May L, Miller LG (2016) Relationship between adherence to oral antibiotics and postdischarge clinical outcomes among patients hospitalized with staphylococcus aureus skin infections. Antimicrob Agents Chemother 60:2941–2948CrossRefPubMedPubMedCentral Eells SJ, Nguyen M, Jung J, Macias-Gil R, May L, Miller LG (2016) Relationship between adherence to oral antibiotics and postdischarge clinical outcomes among patients hospitalized with staphylococcus aureus skin infections. Antimicrob Agents Chemother 60:2941–2948CrossRefPubMedPubMedCentral
69.
go back to reference Canut A, Isla A, Rodriguez-Gascon A (2015) Pharmacokinetic/pharmacodynamic analysis to evaluate ceftaroline fosamil dosing regimens for the treatment of community-acquired bacterial pneumonia and complicated skin and skin-structure infections in patients with normal and impaired renal function. Int J Antimicrob Agents 45:399–405CrossRefPubMed Canut A, Isla A, Rodriguez-Gascon A (2015) Pharmacokinetic/pharmacodynamic analysis to evaluate ceftaroline fosamil dosing regimens for the treatment of community-acquired bacterial pneumonia and complicated skin and skin-structure infections in patients with normal and impaired renal function. Int J Antimicrob Agents 45:399–405CrossRefPubMed
70.
go back to reference Furtek KJ, Kubiak DW, Barra M, Varughese CA, Ashbaugh CD, Koo S (2016) High incidence of neutropenia in patients with prolonged ceftaroline exposure. J Antimicrob Chemother 71:2010–2013CrossRefPubMed Furtek KJ, Kubiak DW, Barra M, Varughese CA, Ashbaugh CD, Koo S (2016) High incidence of neutropenia in patients with prolonged ceftaroline exposure. J Antimicrob Chemother 71:2010–2013CrossRefPubMed
71.
go back to reference Patel N, Cardone K, Grabe DW, Meola S, Hoy C, Manley H, Drusano GL, Lodise TP (2011) Use of pharmacokinetic and pharmacodynamic principles to determine optimal administration of daptomycin in patients receiving standardized thrice-weekly hemodialysis. Antimicrob Agents Chemother 55:1677–1683CrossRefPubMedPubMedCentral Patel N, Cardone K, Grabe DW, Meola S, Hoy C, Manley H, Drusano GL, Lodise TP (2011) Use of pharmacokinetic and pharmacodynamic principles to determine optimal administration of daptomycin in patients receiving standardized thrice-weekly hemodialysis. Antimicrob Agents Chemother 55:1677–1683CrossRefPubMedPubMedCentral
72.
go back to reference Burnham JP, Burnham CA, Warren DK, Kollef MH (2016) Impact of time to appropriate therapy on mortality in patients with vancomycin intermediate Staphylococcus aureus infection. Antimicrob Agents Chemother 60:5546–5553CrossRefPubMed Burnham JP, Burnham CA, Warren DK, Kollef MH (2016) Impact of time to appropriate therapy on mortality in patients with vancomycin intermediate Staphylococcus aureus infection. Antimicrob Agents Chemother 60:5546–5553CrossRefPubMed
73.
go back to reference Flanagan S, Bartizal K, Minassian SL, Fang E, Prokocimer P (2013) In vitro, in vivo, and clinical studies of tedizolid to assess the potential for peripheral or central monoamine oxidase interactions. Antimicrob Agents Chemother 57:3060–3066CrossRefPubMedPubMedCentral Flanagan S, Bartizal K, Minassian SL, Fang E, Prokocimer P (2013) In vitro, in vivo, and clinical studies of tedizolid to assess the potential for peripheral or central monoamine oxidase interactions. Antimicrob Agents Chemother 57:3060–3066CrossRefPubMedPubMedCentral
74.
go back to reference Panackal AA, Hajjeh RA, Cetron MS, Warnock DW (2002) Fungal infections among returning travelers. Clin Infect Dis 35:1088–1095CrossRefPubMed Panackal AA, Hajjeh RA, Cetron MS, Warnock DW (2002) Fungal infections among returning travelers. Clin Infect Dis 35:1088–1095CrossRefPubMed
75.
go back to reference Uys A, Rapoport BL, Anderson R (2004) Febrile neutropenia: a prospective study to validate the Multinational Association of Supportive Care of Cancer (MASCC) risk-index score. Support Care Cancer 12:555–560CrossRefPubMed Uys A, Rapoport BL, Anderson R (2004) Febrile neutropenia: a prospective study to validate the Multinational Association of Supportive Care of Cancer (MASCC) risk-index score. Support Care Cancer 12:555–560CrossRefPubMed
Metadata
Title
Diagnosis and management of skin and soft tissue infections in the intensive care unit: a review
Authors
Jason P. Burnham
John P. Kirby
Marin H. Kollef
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 12/2016
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-016-4576-0

Other articles of this Issue 12/2016

Intensive Care Medicine 12/2016 Go to the issue

What's New in Intensive Care

Alternatives to antibiotics