[Prospective detection of important bacterial pathogens in pyoderma and their in vitro antibiotic susceptibility].
OBJECTIVE
For rational therapeutic recommendations the spectrum and resistance of bacteria in skin diseases were investigated.


METHODS
Within 4 months 911 swabs of dematoses possibly caused by bacteria were taken prospectively (481 outpatients, 430 inpatients) and the material cultured on standard media. The positive cultures including resistance screening of 210 swabs of 168 outpatients and of 175 swabs of 85 inpatients could be evaluated, the remaining cultures were sterile.


RESULTS
Staphylococcus aureus was the most frequent pathogen (outpatient 67%, inpatient 61% of all positive cultures), followed by streptococci (groups A and B; 25%). In patients Pseudomonas aeruginosa was the most common pathogen in leg ulcers and between the toes (45% and 70% respectively). 13% of the Staphylococcus aureus isolates were resistant to tetracyclines and erythromycin; one strain proved to be methicillin resistant.


CONCLUSIONS
Cephalosporins (I. generation), penicillins with beta-lactamase-inhibitors, and to a lesser extent isoxazoyl-penicillin and clindamycin can be recommended for the treatment of skin infections. Oral quinolones are suited for infections with gram-negative bacteria (such as bewteen the toes). The indications for systemic antibiotic therapy of leg ulcers should be restricted.
Ochsendorf
F R
FR
Zentrum Dermatologie und Venerologie, Universitätsklinik Frankfurt. ochsendorf@em.uni-frankfurt.de
Richter
T
T
Niemczyk
U M
UM
Schäfer
V
V
Brade
V
V
Milbradt
R
R
D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology*; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D018432:Drug Resistance, Multiple; D005858:Germany; D006801:Humans; D008826:Microbial Sensitivity Tests; D011446:Prospective Studies; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000382:microbiology; D011711:Pyoderma / Q000188:drug therapy / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000382:microbiology; D013290:Streptococcal Infections / Q000188:drug therapy / Q000382:microbiology
Prospektive Erfassung wichtiger bakterieller Erreger von Pyodermien und deren In-vitro-Antibiotikaempfindlichkeit.