Bacterial Infections of skin-1.pptx......

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1. BACTERIAL INFECTIONS OF SKIN BY AROOB IFTIKHAR & OSAMA RASOOL QADRI MBBS 4 th YEAR KMDC & ASH

2. What are Bacterial skin Infections? Skin infections can be caused by bacteria (often Staphylococcal or Streptococcal) either invading normal skin, or affecting a compromised skin barrier (e.g. skin affected by atopic dermatitis, or surgical wound sites). Skin is our first line of protection against the environment. A local or systemic response is activated when this protective barrier is invaded. Microorganisms that invade the skin can be part of the external environment or the normal skin microbiome.

3. Risk Factors Bacterial Skin Infections People with diabetes, who are likely to have poor blood flow (especially to the hands and feet), have a high level of sugar (glucose) in their blood, which decreases their ability to fight infections People who are hospitalized or living in a nursing home People who have human immunodeficiency virus (HIV), AIDS or other immune disorders People who are undergoing chemotherapy or treatment with other medications that suppress the immune system

4. How Bacteria enter the Skin? The skin provides a remarkably good barrier against bacterial infections. Although many bacteria come in contact with or reside on the skin, they are normally unable to establish an infection. When bacterial skin infections do occur, they can range in size from a tiny spot to the entire body surface. They can range in seriousness as well, from harmless to life threatening. Bacterial skin infections develop when bacteria enter through hair follicles or through small breaks in the skin that result from scrapes, punctures, surgery, burns, sunburn, animal or insect bites, wounds, and pre-existing skin disorders. People can develop bacterial skin infections after participating in a variety of activities, for example, gardening in contaminated soil or swimming in a contaminated pond, lake, or ocean.

5. Which Bacteria cause skin infections? Although there are many species of bacteria that can cause skin Infections but most common bacteria for causing skin infections are STAPHYLOCOCCUS SPECIES and STREPTOCOCCUS SPECIES

6. Infections Caused By Staphylococcus Aureus Cellulitis Folliculitis Furuncles (boils) and abscesses Impetigo (school sores) and Scalded skin syndrome Staphylococcal Toxic shock syndrome Ecthyma Hidradenitis Suppurativa Paronychia

7. Infections Caused By Streptococcus Pyogenes Cellulitis Erysipelas Impetigo Necrotising fasciitis Infectious gangrene Streptococcal Toxic Shock Syndrome

8. Cellulitis Cellulitis is a bacterial infection of your skin and tissues beneath your skin. It most commonly affects the lower parts of your body, including your legs, feet and toes. However, it can occur in any part of your body. It also commonly appears on your face, arms, hands and fingers Staphylococcus and streptococcus bacteria are the most common causes of cellulitis DIAGNOSIS Blood and skin samples may be taken to confirm the diagnosis and the type of bacteria that is present. A bacterial culture can identify the organism causing the condition and indicate the most effective antibiotic

9. TREATMENT Cellulitis treatment usually includes prescription oral antibiotic

10. FOLLICULITIS A common skin condition, folliculitis happens when a hair follicle becomes infected or inflamed This condition may look like acne, often starting out as small red bumps. You can have folliculitis on your face, arms, back and legs TREATMENT Use of oral antibiotics Lotion Creams DIAGNOSIS Swab Collection from skin and culture

11. FURUNCLES Boils (furuncles) usually start as reddish or purplish, tender bumps. The bumps quickly fill with pus, growing larger and more painful until they rupture and drain. Areas most likely to be affected are the face, back of the neck, armpits, thighs and buttocks TREATMENT Treatment is aimed at incision and drainage of the pus. If a carbuncle or furuncle is complicated by fever or cellulitis, treatment with a semisynthetic penicillin is indicated: oral dicloxacillin, flucloxacillin, cefalexin, clindamycin or erythromycin DIAGNOSIS A sample of the pus may be sent to the lab for testing *Most carbuncles are caused by Staphylococcus aureus. A carbuncle is a cluster of several skin boils (furuncles). The infected mass is filled with fluid, pus, and dead tissue

12. IMPETIGO Impetigo is a common and highly contagious skin infection that mainly affects infants and young children. It usually appears as reddish sores on the face, especially around the nose and mouth and on the hands and feet. Over about a week, the sores burst and develop honey- colored crusts TREATMENT Impetigo is treated with mupirocin antibiotic ointment or cream applied directly to the sores two to three times a day for five to 10 days DIAGNOSIS Bacterial cultures can be used for confirmation of diagnosis and should be obtained if methicillin-resistant staph aureus (MRSA) is suspected or if an impetigo outbreak is present. A skin biopsy may be considered if the case is refractory.

13. SCALDED SKIN SYNDROME Staphylococcal scalded skin syndrome (SSSS), is a specific type of scalded skin syndrome caused by certain strains of Staphylococcus aureus bacteria. This bacterial infection releases toxins that target specific proteins in the skin, leading to the characteristic symptoms of skin peeling, blistering, and redness. DIAGNOSIS To confirm the presence of Staphylococcus aureus and its role in causing SSSS, a bacterial culture of skin samples, fluid from blisters, or other affected areas may be collected. The culture helps identify the specific strain of bacteria and determine antibiotic susceptibility .

14. Antibiotic therapy is a key component of treating SSSS, as it helps to eliminate the Staphylococcus aureus bacteria causing the infection. Intravenous antibiotics are typically used to ensure effective delivery and absorption. Commonly used antibiotics for SSSS may include anti-staphylococcal antibiotics such as flucloxacillin or clindamycin . Treatment

15. ECYTHMA Ecthyma is a type of skin infection caused by bacteria, usually Streptococcus or Staphylococcus. It is characterized by painful ulcers or sores that develop on the skin, often on the legs or buttocks. TREATMENT Treatment for ecthyma typically involves a combination of antibiotics and good wound care. The specific antibiotic prescribed will depend on the bacteria causing the infection and its antibiotic sensitivity. Commonly used antibiotics for treating ecthyma include penicillin, dicloxacillin, or erythromycin . DIAGNOSIS Swab or sample of the wound may be taken to identify the specific bacteria causing the infection.

16. PARONYCHIA Paronychia is a common and painful infection that occurs around the nails This type of infection is often acute in nature and is commonly caused by bacteria such as Staphylococcus aureus. It can occur when bacteria enter the skin around the nail through cuts, hangnails, or other breaks in the skin TREATMENT Applying an antibiotic ointment to the infected area can help kill the bacteria and prevent the infection from spreading DIAGNOSIS Swab of the infected area may be taken to determine the specific bacteria causing the infection. This can help guide treatment decisions, especially if the infection does not respond to initial treatment.

17. HYDRADENITIS SUPPURATIVA Hidradenitis suppurativa (HS) is a painful, long-term skin condition that causes skin abscesses and scarring on the skin. The exact cause of hidradenitis suppurativa is unknown, but it occurs near hair follicles where there are sweat glands, usually around the groin, bottom, breasts and armpits. TREATMENT Antibiotics: Topical or oral antibiotics may be prescribed to target the bacterial infection and reduce inflammation. In some cases, cultures of the infected material may be obtained to guide antibiotic therapy. Drainage: Incision and drainage of abscesses or nodules may be necessary to remove infected material and promote healing DIAGNOSIS Skin biopsy Blood culture

18. TOXIC SHOCK SYNDROME Toxic shock syndrome (TSS) is a rare, potentially life-threatening condition caused by toxins produced by certain strains of Staphylococcus aureus (staph) bacteria, most commonly Staphylococcus aureus. While TSS is most commonly associated with tampon use in women, it can also occur in other situations, including skin infections such as bacterial hidradenitis suppurativa TREATMENT Administration of antibiotics: Intravenous antibiotics, such as clindamycin or vancomycin, are typically used to target the bacterial infection and halt toxin production. Supportive care: Treatment in an intensive care setting may be necessary to stabilize blood pressure, provide fluids, and support organ function

19. Blood tests: Samples of blood may be taken to check for signs of infection, including elevated white blood cell count and inflammatory markers. Cultures: Swabs or tissue samples from the skin lesions may be collected and sent for laboratory analysis to determine the presence of Staphylococcus aureus and its susceptibility to antibiotics. Toxin Testing: Some laboratories may perform tests to detect specific toxins produced by Staphylococcus aureus strains associated with TSS Diagnosis

20. ERYSIPELAS Erysipelas is a bacterial skin infection caused by group A Streptococcus bacteria. This infection typically affects the outer layers of the skin and can result in red, swollen, and painful patches on the skin. Erysipelas is more common in children and older adults, as well as individuals with compromised immune systems TREATMENT Oral antibiotics: In mild cases, oral antibiotics such as penicillin or cephalosporins are often prescribed. It is important to take the full course of antibiotics as prescribed by your healthcare provider. Intravenous antibiotics: In severe cases or if oral antibiotics are not effective, intravenous (IV) antibiotics may be necessary. Hospitalization may be required for IV antibiotic administration . DIAGNOSIS CBC Blood Culture

21. NECROTIZING FASCIITIS Necrotizing fasciitis is a severe and potentially life-threatening bacterial infection that involves the rapid destruction of skin, fat, and muscle tissues TREATMENT Surgical debridement plus penicillin and clindamycin are the current standard of care DIAGNOSIS Blood Tests: Blood tests, such as complete blood count (CBC), inflammatory markers (e.g., C-reactive protein, erythrocyte sedimentation rate), and blood cultures, help identify signs of infection and inflammation. Wound Culture: Taking a sample from the affected tissue for wound culture helps identify the specific bacteria causing the infection, including Streptococcus, which is commonly associated with necrotizing fasciitis.

22. Streptococcal toxic shock syndrome (STSS) Streptococcal toxic shock syndrome (STSS) is a serious, life-threatening condition caused by certain strains of group A Streptococcus bacteria, particularly Streptococcus pyogenes. STSS is characterized by the rapid onset of shock, multiorgan dysfunction, and a systemic inflammatory response that can lead to severe complications if not promptly treated. Here is an overview of the diagnosis and treatment of Streptococcal toxic shock syndrome DIAGNOSIS Blood tests are essential for diagnosis and include: Complete blood count (CBC). Inflammatory markers (e.g., C-reactive protein, procalcitonin). Coagulation studies. Blood cultures to identify the causative bacteria

23. TREATMENT: Hospitalization: Patients with suspected STSS require immediate hospitalization in an intensive care unit (ICU) for close monitoring and management of their condition. Antibiotic Therapy: Prompt initiation of broad-spectrum antibiotics is crucial: Empiric antibiotics typically include intravenous beta-lactams (e.g., penicillin, clindamycin) that cover group A Streptococcus. Adjust antibiotic therapy based on culture and sensitivity results