Interventions for cellulitis and erysipelas
Kilburn SA et al. – The authors identified 25 randomised controlled trials. No two trials investigated the same antibiotics, and there was no standard treatment regime used as a comparison. The authors are not able to define the best treatment for cellulitis and their limited conclusions are mostly based on single trials. No single treatment was clearly superior. Surprisingly, oral antibiotics appeared to be more effective than antibiotics given into a vein for moderate and severe cellulitis. This merits further study. Antibiotics given by injection into a muscle were as effective as when given into a vein, with a lower incidence of adverse events. In one study the addition of corticosteroids to an antibiotic appeared to shorten the length of hospital stay, however further trials are needed. A single small study indicated vibration therapy may increase the rate of recovery but the results of single trials should be viewed with caution. The authors had insufficient data to give meaningful results for adverse events.
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Exposure of emergency medical responders to methicillin-resistant Staphylococcus aureus
Sexton JD et al. – EMR have a high potential for exposure to MRSA, not only through patient and hospital contacts but also in the fire station environment. MRSA was isolated with the highest frequency on the couches and the class desks. Although the true health significance of these exposures is unknown, improved infection control practices, such as routine handwashing and surface disinfection, are warranted to reduce MRSA exposures. read more
Outbreak of vancomycin-resistant enterococci in a tertiary hospital: The lack of effect of measures directed mainly by surveillance cultures and differences in response between Enterococcus faecium and Enterococcus faecalis
Pereira GH et al. – Infections by VR–E faecalis fell to zero in 2008. The authors observed difficulties in controlling colonization with measures directed mainly by surveillance cultures and differences between responses of E faecium and E faecalis.
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Multidrug-Resistant Acinetobacter baumannii: An Emerging Pathogen among Older Adults in Community Hospitals and Nursing Homes
Sengstock DM et al. – The prevalence and resistance of Acinetobacter species are increasing in the community. Patients with resistant isolates are selectively discharged to nursing homes and long-term acute-care facilities, introducing resistance to new facilities. read more
The Presentation, Incidence, Etiology, and Treatment of Surgical Site Infections After Spinal Surgery
Ter Gunne P et al. – Deep SSI following spinal surgery was effectively treated with single stage debridement and intravenous antibiotics. Superficial SSI could be treated effectively with local wound care and oral antibiotic therapy.
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