Etiology, Clinical Manifestation and Management of Bacterial Skin and Soft Tissue Infections

The skin is a medium for controlled bacterial growth. It supports the growth of commensal bacteria, which protect the host from pathogenic bacteria. Environmental and local factors, host immunity, and organism adherence and virulence are intricately related to skin infection. Resident gram positive bacteria include Staphylococcus, Micrococcus, and Corynebacterium sp. Staphylococcus aureus and Streptococcus pyogenes are notoriously pathogenic in the skin. In order for bacteria to be pathogenic, they must be able to adhere to, grow on, and invade the host. The organisms possess numerous virulence genes that allow for growth in these privileged niches. Epidermal infections caused by S. aureus and S. pyogenes include impetigo and ecthyma. Dermal infections consist of erysipelas, cellulitis, and necrotizing fasciitis. The follicular infections include folliculitis, furunculosis, and carbunculosis. Moreover, S. aureus and S. pyogenes produce toxins that may elicit a superantigen response, causing massive release of cytokines. Gram-negative organisms such as Pseudomonas aeruginosa, Pasteurella multocida, Bartonella sp., Klebsiella rhinoscleromatis, and Vibrio vulnicus are not typical resident skin micro-flora but may cause cutaneous infection. Recognition of the potential for resistant pathogens causing skin and soft tissue infections (SSTIs) can assist in guiding appropriate selection of antibiotic therapy. The aim of this article is to reviews the etiology, pathogenesis, clinical manifestation, associated risk factors, and the treatment of SSTIs

Keywords: Bacteria, clinical manifestation, etiology, skin infection, soft tissue infection.