title: Host factors that contribute to recurrent staphylococcal skin infection.
abstract: OBJECTIVE
  Staphylococcus aureus is the most common cause of skin and soft tissue infections (SSTI) in the United States and elsewhere. Recurrent infections occur frequently in patients with S. aureus SSTI, underscoring the need to better understand the nature of protective immunity against these infections. Here, we review recent findings concerning the host factors that predispose to S. aureus SSTI.
  
  
  RESULTS
  Recurrent infections occur in nearly half of all patients with S. aureus SSTI. Epidemiologic and environmental factors, such as exposure to healthcare, age, and household contacts with S. aureus SSTI, and contaminated household fomites are associated with recurrence. The majority of the population has evidence of antistaphylococcal antibodies, but whether these are protective remains enigmatic. In contrast, recent clinical and experimental findings clearly highlight the critical roles of innate and T cell-mediated immunity in defense against these infections. S. aureus interferes with innate and adaptive immunity by a number of recently elucidated mechanisms.
  
  
  CONCLUSIONS
  Recurrent S. aureus SSTIs are common, suggesting incomplete or absent protective immunity among these patients. Our understanding of protective immunity against recurrent infections is incomplete, and further basic and translational investigation is urgently needed to design strategies to prevent and treat these infections.
authors.affiliation: aSections of Critical Care bInfectious Diseases, Department of Pediatrics cSection of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, Chicago, Illinois, USA.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Montgomery
authors.forename: Michael Z
authors.initials: MZ
authors.lastname: David
authors.forename: Robert S
authors.initials: RS
authors.lastname: Daum
mesh_terms: D056704:Adaptive Immunity / Q000276:immunology*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000907:Antibodies, Bacterial / Q000097:blood; D054884:Host-Pathogen Interactions / Q000276:immunology*; D006801:Humans; D006920:Hygiene / Q000592:standards; D007111:Immunity, Cellular; D007113:Immunity, Innate; D012307:Risk Factors; D055502:Secondary Prevention; D013207:Staphylococcal Skin Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology* / Q000473:pathology; D013211:Staphylococcus aureus / Q000472:pathogenicity*
chemical_list: D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial