Gram-negative bacterial toe web infection: A survey of 123 cases from the district of Cagliari, Italy
Gram-negative bacterial toe web infection: A survey of 123 cases from the district of Cagliari, Italy
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DOI：
10.1067/mjd.2001.114747
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发表时间：
2001-10-01
影响因子：
13.8
通讯作者：
Biggio, P
中科院分区：
文献类型：
--
作者：
Aste, N;Atzori, L;Biggio, P
背景足擦烂病主要由皮肤真菌和酵母菌引起，较少由革兰氏阳性和革兰氏阴性细菌引起。然而，多种微生物感染的重要性，特别是铜绿假单胞菌的定植，可能会导致抗生素耐药性和潜在致命并发症的风险相关的治疗问题。目的：本研究的目的是评估主要的流行病学和临床特征的革兰阴性菌擦烂，促进因素的作用，以及采取措施，以治疗和预防这种疾病。1989年至1998年，在卡利亚里大学皮肤科观察到123例革兰氏阴性菌引起的擦烂病。进行常规临床和血液检查、反复细菌镜和真菌学检查、旨在鉴定致病菌的培养和细菌培养。铜绿假单胞菌被认为是主要的病原体，无论是单独的还是与其他革兰氏阴性菌（如大肠杆菌，奇异变形杆菌，摩根氏菌）和革兰氏阳性菌。大多数患者的临床表现相似：红斑、水疱、糜烂和大量恶臭渗出物引起的明显浸渍。病变累及双足趾间间隙，经常延伸至足底和脚趾后部。患者主诉有烧灼感和疼痛。成功的治疗取得了局部和全身治疗相结合，以避免抗菌药物耐药性的风险，活性抗生素的选择是指导的bigrammes.Conclusion：在所有有症状的趾蹼感染，革兰氏阴性菌的存在下，如铜绿假单胞菌，应进行调查，以避免治疗失败和更严重的局部或全身并发症的风险。
Background. Foot intertrigo is mostly caused by dermatophytes and yeasts, less frequently by grampositive and gram-negative bacteria. Nevertheless, the importance of polymicrobial infections and especially colonizations of Pseudomonas aeruginosa can cause therapy problems in relation to antibiotic resistance and the risk of potentially lethal complications.Objective: The aim of this study was to evaluate the main epidemiologic and clinical features of intertrigo from gram-negative bacteria, the function of promoting factors, and the measures taken to treat and prevent this disorder.Methods: Between 1989 and 1998, 123 cases of intertrigo from gram-negative bacteria were observed at the Cagliari University Dermatology Department. Routine clinical and blood examinations, repeated bacterioscopic and mycologic examinations, cultures aimed at identifying the responsible bacteria, and antibiograms were performed.Results. P aeruginosa was found to be the prevailing pathogen, both alone and associated with other gram-negative bacteria (such as Escherichia coli, Proteus mirabilis, Morganella morganii) and grampositive bacteria. Clinical manifestations were similar in the majority of patients: erythema, vesicopostules, erosions, and marked maceration caused by abundant, malodorous exudate, Lesions affected the interdigital spaces of both feet and frequently extended to the planta and the back of the toes. Patients complained of burning and pain. Successful therapies were achieved with combined topical and systemic treatment; to avoid the risk of antimicrobial resistance, the choice of the active antibiotic was guided by antibiograms.Conclusion: In all symptomatic toe web infections, the presence of gram-negative germs, such as P aeruginosa, should be investigated to avoid the risk of treatment failures and more severe local or systemic complications.