Infección de piel y partes blandas por Vibrio vulnificus. Comunicación de un caso diagnosticado en Argentina / Vibrio vulnificus infection of the skin and soft parts. Communication of a case diagnosed in Argentina

Resumen Vibrio vulnificus es una de las especies de Vibrio más virulentas que se conocen. Es una bacteria de distribución universal. El primer caso registrado en Uruguay se produjo en 2001, y desde entonces ocurren varias infecciones por año. Recientemente, en ese país, V. vulnificus fue responsable de una infección de partes blandas de curso letal. Aunque no han sido comunicados casos de infección humana por esta especie en Argentina, se ha identificado recientemente Vibrio vulnificus en muestras asociadas con microplancton en el estuario del Río Negro. Presentamos el caso de una infección grave de piel y partes blandas por V. vulnificus a partir de una herida abierta en un paciente en contacto con medio acuático marino en la costa de Uruguay del Río de la Plata. El aislamiento de vibrios en muestras de heridas puede causar un daño en los tejidos con rápida progresión, en particular V. vulnificus, que tiene una alta mortalidad sin la precoz y apropiada intervención. En nuestro caso, la rápida identificación del microorganismo permitió avalar el tratamiento empírico utilizado, con una buena evolución clínica.

Abstract Vibrio vulnificus is one of the most virulent Vibrio species known. It is a bacterium with universal distribution. The first case registered in Uruguay occurred in 2001 and, since then, several infections have occurred per year. Recently, in this country, V. vulnificus was responsible for a fatal soft tissue infection. Although no cases of human infection with this species have been reported in Argentina, researchers have recently identified V. vulnificus in samples associated with microplankton in the Rio Negro estuary. We present the case of a severe skin and soft tissue infection by V. vulnificus from an open wound in a patient in contact with a marine aquatic environment on the coast of the River Plate, in Uruguay. Isolation of vibrios from wound specimens can cause rapidly progressing tissue damage, particularly V. vulnificus which has a high mortality rate without early and appropriate intervention. In our case, the rapid identification of the microorganism allowed us to support the empirical treatment used, which a good clinical evolution.

Clinical features and laboratory data analysis of Aeromonas bacteremia with hematological diseases / 中华血液学杂志

Objective@#To investigate the clinical and laboratory features of Aeromonas bacteremia in patients with hematological diseases, and provide evidence for the prevention and treatment of Aeromonas infection.@*Methods@#A retrospective study of patients with bloodstream infection of Aeromonas in our hospital from January 2014 to December 2018 was carried out. The clinical characteristics, antimicrobial susceptibility, infection seasons, antimicrobial therapy and evolution were analyzed.@*Results@#A total of 42 patients with hematological diseases had Aeromonas bloodstream infection within 5 years. Among them, 39 cases (92.9%) of bloodstream infection occurred in the stage of neutropenia. The median time of fever was 4 (1-27) d, 22 (52.4%) patients only had fever, 6 (14.3%) with gastrointestinal symptoms (abdominal pain, diarrhea, nausea, upper gastrointestinal bleeding) , 8 (19.0%) with pulmonary infection, 13 (31.0%) with skin and soft tissue infections. Seven patients (16.7%) died with skin and soft tissue infection. The resistance of Aeromonas to carbapenems was 68.3%-70.7%, while the resistance rate to cephalosporins, quinolones and aminoglycosides were less than 10%.@*Conclusions@#Aeromonas bacteremia in patients with hematological diseases mainly occur in the neutropenia stage, usually with symptom like fever. The mortality is increased when accompanied by skin and soft tissue infection. Antibiotic use should be based on susceptibility results, and avoid the use of carbapenems.

Retrospective analysis of methicillin-resistant staphylococcus aureus skin and soft tissue infection among patients admitted at an academic university hospital from 2011 to 2015: A five-year review

Introduction@#The emergence of methicillin-resistant Staphylococcus aureus (MRSA) is a challenge in the management of skin and soft tissue infections (SSTIs). @*Objective@#To describe the epidemiology of MRSA SSTIs among admitted patients at the University of Santo Tomas Hospital (USTH).@*Methods @#This was a retrospective study of inpatients with MRSA SSTIs from 2011-2015. MRSA infections were classii ed as community-associated (CA-MRSA) and healthcare-associated (HA-MRSA). Demographic characteristics, clinical proi le, comorbidities, complications, risk factors, antibiotic susceptibility and resistance, treatment used, and clinical outcome were determined.@*Results@#Out of the 331 inpatients with Staphylococcus aureus SSTIs, 211 had MRSA with a prevalence of 63.7%, 80.1% of MRSA were CAMRSA while 19.9% were HA-MRSA. The mean age was 41.58 years with male predominance. The majority presented with abscess (62.9%), on the legs (21.8%). The abscess was signii cantly associated with CA-MRSA while infected wounds, previous hospitalization, and surgery were correlated with HA-MRSA. Growing resistance to ciprol oxacin, tetracycline, macrolides, co-trimoxazole, and clindamycin was noted. A low percentage of resistance to vancomycin and linezolid was observed. Almost all cases improved with appropriate antibiotic therapy and 3.3% mortality@*Conclusion@#More than half of the patients with Staphylococcus aureus SSTIs had MRSA. and were mostly CA-MRSA and males. Abscess on the leg was the common presentation and signii cantly associated with CA-MRSA. Infected wounds, previous hospitalization, and surgery were associated with HA-MRSA. There was high resistance of MRSA to ciprol oxacin and tetracycline while low resistance to vancomycin and linezolid. Almost all improved with appropriate treatment.

Multicenter study on the molecular characteristics of community-associated Methicillin-resistant Staphylococcus aureus in children with skin and soft tissue infection / 中华实用儿科临床杂志

Objective To explore the molecular characteristics of community-associated Methicillin-resistant Staphylococcus aureus (CA-MRSA) from children with skin and soft tissue infection (SSTIs) in China.Methods CA-MRSA was collected from the outpatients in Department of Dermatology in 13 Children's Hospitals of China.Genotypic characteristics of CA-MRSA isolates were tested by adopting mnltilocus sequence typing (MLST),staphylococcal protein A (spa) typing and Staphyloccoccal cassette chromosome mec (SCCmec) typing.And the presence of Panton-Valentine leukocidin genes(pvl) was determined also.Results Overall,1 705 strains of Staphylococcus aureus were isolated from SSTIs children,and CA-MRSA accounted for 2.6％ (44/1 705 strains).Two types of SCCmec were detected in all the CA-MRSA strains,and the main types were SCCmec Ⅳ and SCCmec Ⅴ,accounting for 45.5 ％ (20/44 strains) and 54.5 ％ (24/44 strains),respectively.Thirteen MLST types (STs) and 15 spa types were detected among CA-MRSA.The most prevalent MLST was ST121 (18/44 strains,40.9％),followed by ST59 (9/44 strains,20.5％).Additionally,t437 was predominant,accounting for 40.9％ (18/44 strains).ST121 strain had 8 spa types,and t2086 was the most common type (6/18 strains,33.3％);while ST59 had only 1 spa type,t437.No ST121,ST59 and t437 strains were found in Central and Eastern region of China.Only 4 (9.1％) of the 44 CA-MRSA strains harbored pvl genes which were all from Southern region.Conclusions The most common clone of SSTIs CA-MRSA in children is MRSA-ST121-SCCmec Ⅳ/Ⅴ,as the molecular epidemiology of CA-MRSA strain has changed,ST121 has replaced ST59 to become the main epidemic strains.

Profile of community-acquired Methicill in Resistant Staphylococcus Aureus Skin and Soft-Tissue infections among children admitted at the Philipine General Hospital

Abstract@#CA-MRSA infection is a global concern. It is important to determine the local prevalence of CA-MRSA skin and soft-tissue infection as this information will provide a more accurate and rational basis for empiric treatment, improve management and outcomes in patients, and reduce the economic burden associated with failed treatment. This study was conducted to determine the clinical profile and prevalence of CA-MRSA skin and soft tissue infections among pediatric patients admitted at the Philippine General Hospital. @*Methods@#A prospective, observational study was performed involving all pediatric patients admitted at U-PGH for skin and soft tissue infections from September to December 2012. Demographic profile, clinical characteristics of patients, results of laboratory examinations, the outcome of treatment were described and summarized. Risk factors for acquisition of MRSA were also determined. Period-prevalence was computed. @*Results@#There were 25 children admitted for SSTIs, 16 have positive cultures and 62.5% of these had CA-MRSA. The majority were male children younger than 5 years old without identifiable risk factors. infections presented as solitary masses and cellulitis usually at the head and neck area. isolates were taken from aspirates during incision and drainage. Invasive infections were seen 3 patients. The length of hospital stay, type of antibiotics used and surgery performed was variable. All patients were discharge well and there were no mortalities. The period prevalence of CA-MRSA among children with SSTI was 0.36. @*Conclusion@#CA-MRSA as a cause of SSTIs in Filipino children is an emerging concern, especially in very young patients even without risk factors. management of SSTI’s should include incision and drainage of abcesses and prompt submission of aspirates for culture and antibiotic sensitivity testing. The period prevalence of pediatric patients with SSTI is high among hospitalized patients. Empiric antibiotics with MRSA coverage such as clindamycin and vancomycin should be considered clinical situations wherein MRSA is deemed likely.

Lower Limb Infection in an Infant with <i>Haemophilus influenzae</i> Serotype b / General Medicine

We describe a rare case of lower leg infection caused by <i>Haemophilus influenzae</i> serotype b (Hib) in a previously healthy 14-month-old boy. In primary care, <i>H. influenzae</i> is a common pathogen affecting children, and which causes respiratory and central nervous system infection alike. Conversely, skin and soft tissue infections caused by Hib are a somewhat rare occurrence. Beta-lactamase-negative ampicillin-resistant strains have been spreading throughout Japan, although the type of Hib in our case was cephalosporin-sensitive. As a result, we need to pay attention to Hib infection in various clinical settings.

Association of Bacteria with Fungal Infection of Skin and Soft Tissue Lesions in Plateau State, Nigeria.

Aims: To identify and determine the bacteria associated with skin and soft tissue conditions of fungal infections. Place and Duration of Study: Sample area was Plateau State Nigeria and sample collection and analysis was done in Dermatophilosis Research Centre, National Veterinary Research Institute Vom, Plateau State, Nigeria, between September 2011 and December 2012. Methodology: Nine hundred and forty (940) human skin and nail scraping samples from different parts of the body were collected from subjects referred to the Centre from different hospitals with visible skin infections. Sample analysis were carried out using standard microbiological methods which include: Wet mount, tease mount, culture and biochemical tests were used to process and analyze for the isolation and identification of fungi and bacteria. Results: Out of 940 samples, 892(94.9%) yielded fungal species which include: Microsporum 45(4.8%), Trichophyton 176(18.7%), Aspergillus 216(22.9%), Epidermophyton 32(3.4%), Candida 72(7.7%), Mucor 141(15.0%), Rhizopus 52(5.5%), Fusarium 12(1.3%), Bipolaris 23(2.5%), Sporothrix 74(7.9%), Penicillium 32(3.4%) and Curvularia 17(1.8%). All samples 940 (100%) yielded an array of bacteria which include: Staphylococcus aureus 125(13.3%), Staphylococcus epidermidis 145(15.8%), Micrococcus luteus 233(24.8%), α-hemolytic Streptococci 89(9.5%), Escherichia coli 59(6.3%), Proteus mirabilis 113(12%), Bacillus subtilis 78(8.3%) and Klebsiella pneumonia 98(10.4%). Staphylococcus aureus, Staphylococcus epidermidis and Micrococcus luteus were isolated from all sites of infection while Micrococcus luteus was isolated from all moist ulcerous and dry scaly skin infections. Conclusion: This study showed the presence of bacteria in high frequency in and around skin and soft tissue infection sites on the body. Micrococcus luteus was the most prevalent bacterial organism associated with skin and soft tissue conditions of fungal infections. Under favourable conditions, some of the bacteria isolated can establish infections through broken skin hence complicating or prolonging treatment of the skin infection.

The Efficacy and Safety of Arbekacin and Vancomycin for the Treatment in Skin and Soft Tissue MRSA Infection: Preliminary Study

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has become a one of the most important causes of nosocomial infections, and use of vancomycin for the treatment of MRSA infection has increased. Unfortunately, vancomycin-resistant enterococcus have been reported, as well as vancomycin-resistant S. aureus. Arbekacin is an antibacterial agent and belongs to the aminoglycoside family of antibiotics. It was introduced to treat MRSA infection. We studied the clinical and bacteriological efficacy and safety of arbekacin compared to vancomycin in the treatment of infections caused by MRSA. MATERIALS AND METHODS: This was a retrospective case-control study of patients who were admitted to tertiary Hospital from January 1st, 2009 to December 31st, 2010, and received the antibiotics arbekacin or vancomycin. All the skin and soft tissue MRSA infected patients who received arbekacin or vancomycin were enrolled during the study period. The bacteriological efficacy response (BER) was classified with improved and failure. The improved BER was defined as no growth of MRSA, where failure was defined as growth of MRSA, culture at the end of therapy or during treatment. Clinical efficacy response (CER) was classified as improved and failure. Improved CER was defined as resolution or reduction of the majority of signs and symptoms related to the original infection. Failure was defined as no resolution and no reduction of majority of the signs and symptoms, or worsening of one or more signs and symptoms, or new symptoms or signs associated with the original infection or a new infection. RESULTS: Totally, 122 patients (63/99 in arbekacin, 59/168 in vancomycin group) with skin and soft tissue infection who recieved arbekacin or vancomcyin at least 4 days were enrolled and analysed. The bacteriological efficacy response [improved, arbekacin vs vancomycin; 73.0% (46/63), 95% confidence interval (CI) 60.3 to 83.4% vs 83.1% (49/59), 95% CI 71.0 to 91.6%] and clinical efficacy response [improved, arbekacin vs vancomycin; 67.2% (41/61), 95% CI 52.0 to 76.7% vs 78.0% (46/59), 95% CI 65.3 to 87.7%] were similar between the two groups (P=0.264, 0.265). The complication rate was significantly higher in the vancomycin group [29/59(49.2%), 95% CI 35.9 to 62.5%] than arbekacin [10/63(15.9%), 95% CI 8.4 to 29.0%] (P<0.001). CONCLUSIONS: Arbekacin could be considered as an alternative antibiotics for vancomycin in skin and soft tissue infection with MRSA. However, further prospective randomized trials are needed to confirm this finding.

Necrotizing Fasciitis in Three University Hospitals in Korea: A Change in Causative Microorganisms and Risk Factors of Mortality During the Last Decade

BACKGROUND: Necrotizing fasciitis is a life-threatening infectious disease with rapidly progressive involvement of the affected site. Because of the high mortality rate of this disease, early diagnosis, surgical exploration, and administration of appropriate antibiotics are necessary. The present study aimed to further review the changes in the clinical and microbiological characteristics of necrotizing fasciitis using patients' medical records from consecutive databases of 3 hospitals in Korea. MATERIALS AND METHODS: In this study, we retrospectively reviewed the medical records of patients with necrotizing fasciitis who were clinically diagnosed between May 2001 and February 2012 in 3 university hospitals in Korea. In total, the data of 83 patients were analyzed, including those of 20 patients from our previous study in 2006. An organism found in a blood culture or surgical specimen was regarded as a causative organism. RESULTS: Of the 83 patients, 68(81.9%) had community-acquired infections. Ninety microorganism species were indentifed by culture. Streptococcus was the most commonly identified pathogen. Non-fermentative gram-negative bacteria and Candida species have recently emerged, especially in immunocompromised hosts. CONCLUSIONS: Gram-positive organisms are still the most common pathogens of necrotizing fasciitis. However in our study, various gram-negative bacteria with different levels of susceptibility to antibiotics, as well as Candida species, were responsible for the necrotizing fasciitis. Initial empirical antimicrobial agents for necrotizing fasciitis should be considered depending on the individual patient's condition.

Skin and Soft Tissue Infection Caused by Mycobacterium abscessus Developed after Intramuscular Injection: A Case Report

Mycobacterium abscessus is a rapidly-growing bacterium which spreads everywhere in the natural world. Lung infection is the most common infection that it causes, but skin and soft tissue infections can occur after injections, operations, or other trauma. We report a case of subcutaneous infection caused by M. abscessus followed by an intramuscular injection.

Incidence of Community-associated Methicillin-resistant Staphylococcus aureus Infections in a Regional Hospital / Journal of Rural Medicine

Background and Objective: Since the early 2000s, the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections among the community of people lacking known healthcare risk factors has increased. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection and is distinct from hospital-associated MRSA (HA-MRSA) infection, which occurs among people with known healthcare risk factors. Understanding the epidemiology of CA-MRSA infections is critical; however, this has not been investigated in detail in Japan. Our objective was to investigate the incidence of CA-MRSA infections in a regional hospital. Patients and Methods: We investigated CA-MRSA isolates and infections in a rural regional hospital by reviewing medical records of one year. Infections were classified as CA-MRSA if no established risk factors were identified. Results: During 2008, 31 Staphylococcus aureus (S. aureus) isolates were detected in 29 unique patients, with 1 methicillin-sensitive S. aureus (MSSA) isolates obtained from 19 patients (66%) and MRSA obtained from 10 patients (34%). In the 10 patients with MRSA, the number of HA-MRSA and CA-MRSA cases were nine (32% of patients with S. aureus isolates) and one (3%), respectively. The patient with CA-MRSA was diagnosed with cellulitis due to CA-MRSA. All nine patients with HA-MRSA exhibited colonization. Conclusion: We observed a CA-MRSA case in a regional hospital in Japan, suggesting that incidence trends of CA-MRSA should be considered in future research and treatment.

Incidence of Community-associated Methicillin-resistant Staphylococcus aureus Infections in a Regional Hospital / Journal of Rural Medicine

<b>Background and Objective:</b> Since the early 2000s, the incidence of methicillin-resistant <i>Staphylococcus aureus</i> (MRSA) infections among the community of people lacking known healthcare risk factors has increased. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection and is distinct from hospital-associated MRSA (HA-MRSA) infection, which occurs among people with known healthcare risk factors. Understanding the epidemiology of CA-MRSA infections is critical; however, this has not been investigated in detail in Japan. Our objective was to investigate the incidence of CA-MRSA infections in a regional hospital. <BR><b>Patients and Methods:</b> We investigated CA-MRSA isolates and infections in a rural regional hospital by reviewing medical records of one year. Infections were classified as CA-MRSA if no established risk factors were identified. <BR><b>Results:</b> During 2008, 31 <i>Staphylococcus aureus</i> (<i>S. aureus</i>) isolates were detected in 29 unique patients, with 1 methicillin-sensitive <i>S. aureus</i> (MSSA) isolates obtained from 19 patients (66%) and MRSA obtained from 10 patients (34%). In the 10 patients with MRSA, the number of HA-MRSA and CA-MRSA cases were nine (32% of patients with <i>S. aureus</i> isolates) and one (3%), respectively. The patient with CA-MRSA was diagnosed with cellulitis due to CA-MRSA. All nine patients with HA-MRSA exhibited colonization. <BR><b>Conclusion:</b> We observed a CA-MRSA case in a regional hospital in Japan, suggesting that incidence trends of CA-MRSA should be considered in future research and treatment.

A Case of Community-Associated Methicillin-Resistant Staphylococcus Aureus Infections in a Community Hospital / Journal of Rural Medicine

Infections caused by methicillin-resistant <i>Staphylococcus Aureus</i> (MRSA) have recently occurred in communities in people lacking known healthcare risk factors. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection, and is distinct from hospital-associated MRSA infection, which occurs in people with risk factors. We experienced a patient diagnosed with CA-MRSA cellulitis, as culture of pus revealed MRSA and he had not been exposed to healthcare environments for the past year. The patient was a previously healthy 38-year-old man with suppurative cellulitis in his right index finger following injury to the finger at his worksite. The cellulitis was successfully managed with incision and drainage (I&D), followed by cefazolin during a 10-day clinical course, although the patient’s MRSA strain was resistant to cefazolin. There are several reports that suggest that I&D followed by antibiotic treatment for CA-MRSA skin infection produces equivalent clinical outcomes, whether the antibiotic prescribed was effective or not. Given that MRSA emerged in an outpatient setting, CA-MRSA should be considered a possible etiology of skin infection in healthy individuals with no classical risk factors for acquisition of MRSA.<br>

A Case of Community-Associated Methicillin-Resistant Staphylococcus Aureus Infections in a Community Hospital / Journal of Rural Medicine

Infections caused by methicillin-resistant Staphylococcus Aureus (MRSA) have recently occurred in communities in people lacking known healthcare risk factors. This MRSA infection is referred to as community-associated MRSA (CA-MRSA) infection, and is distinct from hospital-associated MRSA infection, which occurs in people with risk factors. We experienced a patient diagnosed with CA-MRSA cellulitis, as culture of pus revealed MRSA and he had not been exposed to healthcare environments for the past year. The patient was a previously healthy 38-year-old man with suppurative cellulitis in his right index finger following injury to the finger at his worksite. The cellulitis was successfully managed with incision and drainage (I&D), followed by cefazolin during a 10-day clinical course, although the patient’s MRSA strain was resistant to cefazolin. There are several reports that suggest that I&D followed by antibiotic treatment for CA-MRSA skin infection produces equivalent clinical outcomes, whether the antibiotic prescribed was effective or not. Given that MRSA emerged in an outpatient setting, CA-MRSA should be considered a possible etiology of skin infection in healthy individuals with no classical risk factors for acquisition of MRSA.

The Efficacy and Safety of Linezolid for the Treatment of Suspected or Proven Gram Positive Skin and Soft Tissue Infections

BACKGROUND: Linezolid, an oxazolidinone, has shown efficacy in the treatment of adults with nosocomial or community-acquired pneumonia, skin and soft tissue infections (SSTI), and infections due to methicillin-resistant Staphylococcus aureus. We have taken part in the study for evaluation of efficacy and safety of linezolid for the treatment of suspected or proven gram-positive SSTI in Asia. We sub-analyzed and reported the results of the study among Korean patients. MATERIALS AND METHODS: A total of 60 patients were enrolled in the study for evaluation of efficacy and safety of linezolid for the treatment of gram-positive SSTI at eight teaching hospitals in Korea. We investigated patients' medical history, physical examination and laboratory study. Patients were regularly followed up to evaluate clinical response, laboratory changes, and adverse event up to 4 weeks after treatment. When possible, we performed microbiological study before and after treatment. RESULTS: A total of 60 patients were enrolled. Average age of the patient was 50.9+/-15.3 years old with male to female ratio being 1.3:1. Cellulitis, open wound infection, skin abscess, and other clinical manifestations were observed in 47 (78.3%), 6 (10.0%), 2 (3.3%), and 5 (8.3%) patients, respectively. Forty two patients completed both follow-up and treatment and among them, treatment was successful in 38 patients (90.5%) and unsuccessful in 4 patients (9.5%). Microoranisms were isolated from seven patients and 14 isolates were documented; 11 S. aureus, 3 coagulase-negative staphylococcus. Among the seven patients, bacteria were eradicated in four patient and the organism proved to be colonization in three patients. The most frequent drug-related adverse events were gastrointestinal (21.7%), hematologic and biochemical (21.7%) and neurologic (3.3%), in decreasing order. Nausea (15%) was the most frequent symptom and there were no serious side effects related to linezolid. CONCLUSION: Linezolid was effective and safe in treatment of gram-positive SSTI.

The Efficacy and Safety of Linezolid for the Treatment of Suspected or Proven Gram Positive Skin and Soft Tissue Infections

BACKGROUND: Linezolid, an oxazolidinone, has shown efficacy in the treatment of adults with nosocomial or community-acquired pneumonia, skin and soft tissue infections (SSTI), and infections due to methicillin-resistant Staphylococcus aureus. We have taken part in the study for evaluation of efficacy and safety of linezolid for the treatment of suspected or proven gram-positive SSTI in Asia. We sub-analyzed and reported the results of the study among Korean patients. MATERIALS AND METHODS: A total of 60 patients were enrolled in the study for evaluation of efficacy and safety of linezolid for the treatment of gram-positive SSTI at eight teaching hospitals in Korea. We investigated patients' medical history, physical examination and laboratory study. Patients were regularly followed up to evaluate clinical response, laboratory changes, and adverse event up to 4 weeks after treatment. When possible, we performed microbiological study before and after treatment. RESULTS: A total of 60 patients were enrolled. Average age of the patient was 50.9+/-15.3 years old with male to female ratio being 1.3:1. Cellulitis, open wound infection, skin abscess, and other clinical manifestations were observed in 47 (78.3%), 6 (10.0%), 2 (3.3%), and 5 (8.3%) patients, respectively. Forty two patients completed both follow-up and treatment and among them, treatment was successful in 38 patients (90.5%) and unsuccessful in 4 patients (9.5%). Microoranisms were isolated from seven patients and 14 isolates were documented; 11 S. aureus, 3 coagulase-negative staphylococcus. Among the seven patients, bacteria were eradicated in four patient and the organism proved to be colonization in three patients. The most frequent drug-related adverse events were gastrointestinal (21.7%), hematologic and biochemical (21.7%) and neurologic (3.3%), in decreasing order. Nausea (15%) was the most frequent symptom and there were no serious side effects related to linezolid. CONCLUSION: Linezolid was effective and safe in treatment of gram-positive SSTI.

A Case of Skin and Soft Tissue Infection Caused by Mycobacterium abscessus / 감염

Mycobacterium abscessus (formerly M. chelonae sub-species abscessus) is an acid-fast bacillus classified as pathogenic "rapid growing" nontuberculous mycobacteria. Even though these organisms are ubiquitous in the environment, it is an uncommon cause of human diseases. M. abscessus can cause skin and soft tissue infection associated with a penetrating wound or a foreign body but it can spread to viscera other than the lungs leading to a variety of infections. The single most important factor determining the course and prognosis of M. abscessus infection is the underlying immune status of the hosts. There have been no reports of skin and soft tissue infection caused by M. abscessus in Korea. We experienced a case of skin and soft tissue infection with M. abscessus. A 43-year-old female patient developed necrotizing infection in the skin, soft tissue and fascia in the lower extremity without a definite preceding cause. She was treated successfully with prolonged drug therapy including clarithromycin, and surgical debridement.