WHAT IS THE MEANING OF SKIN AND SOFT-TISSUE INFECTIONS?
Bacterial infections of the skin can be classified as primary or secondary (Table 1–1). Primary bacterial infections are usually caused by a single bacterial species and involve areas of generally healthy skin (e.g., impetigo and erysipelas). Secondary infections, however, develop in areas of previously damaged skin and are frequently polymicrobial.
The conditions that may predispose a patient to the development of skin and soft-tissue infections (SSTIs) include (1) a high concentration of bacteria; (2) excessive moisture of the skin; (3) inadequate blood supply; (4) availability of bacterial nutrients; and (5) damage to the corneal layer, allowing for bacterial penetration.
The majority of SSTIs are caused by gram-positive organisms and, less commonly, gram-negative bacteria present on the skin surface. Staphylococcus aureus and Streptococcus pyogenes account for the majority of SSTIs. Community-associated methicillin-resistant S. aureus (CA-MRSA) has emerged and is often isolated in otherwise healthy patients.
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