title: Microbial ecology of interdigital infections of toe web spaces.
abstract: The microbial flora of normal and macerated interdigital toe web spaces was qualitatively and quantitatively identified in 77 patients. Dermatophyte fungi were recovered from 11% of normal patients compared with a 31% recovery from patients with macerated interspaces. Macerated interspaces were characterized by a greater recovery of organisms with pathogenic potential, with Staphylococcus aureus recovered from 36% of patients, Micrococcus sedentarius in 37%, Brevibacterium epidermidis in 54%, Corynebacterium minutissimum in 69%, and Pseudomonas species in 26%. The bacterial flora of macerated interspaces showed a significantly higher incidence of resistance to multiple antibiotics, and the recovery of antibiotic-resistant bacteria correlated with the recovery of dermatophytes that produce penicillin-like substances. The results of this study support the hypothesis that overgrowth of the resident bacterial population determines the severity of interdigital toe-web infections.
authors.affiliation: Department of Dermatology, School of Medicine, University of Pennsylvania, Philadelphia.
authors.forename: S G
authors.initials: SG
authors.lastname: Kates
authors.forename: K M
authors.initials: KM
authors.lastname: Nordstrom
authors.forename: K J
authors.initials: KJ
authors.lastname: McGinley
authors.forename: J J
authors.initials: JJ
authors.lastname: Leyden
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000187:drug effects / Q000302:isolation & purification; D003881:Dermatomycoses / Q000382:microbiology; D004352:Drug Resistance, Microbial; D005533:Foot Dermatoses / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012874:Skin Diseases, Infectious / Q000382:microbiology*; D014034:Toes