Abstract
Wound cultures represent a general catchall category for a group of extremely diverse anatomic samples that range from superficial specimens of cutaneous structures (folliculitis, cellulitis) to specimens revealing invasive infections involving deep fascial planes and muscle (myonecrosis). Because of the complex nature of these infective processes, the terminology associated with such infections is often imprecise and confusing. Wounds are the result of trauma, either intentionally or accidentally induced. Nosocomial wound infections result primarily from surgical procedures, the development of pressure sores, or catheterization. Community-acquired wound infections are often preceded by injuries resulting from occupational exposure or recreational activities and are associated with a greater diversity of microorganisms due to the exposure of open wounds to inhabitants of the microbial biosphere. This review provides a general overview of the categories of wound infections and describes their acquisition and clinical significance. Particular emphasis is placed on selected community-acquired wound infections and the etiologic agents associated with such conditions.
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References
Heggers JP: Natural host defense mechanisms. Clinics in Plastic Surgery 1979, 6: 505–513.
Rodbard D: The role of regional body temperature in the pathogenesis of disease. New England Journal of Medicine 1981, 305: 808–814.
Mackowiak PA: Medical progress: the normal microbial flora. New England Journal of Medicine 1982, 307: 83–93.
Kahn RM, Goldstein EJC: Common bacterial skin infections: diagnostic clues and therapeutic options. Postgraduate Medicine 1993, 93: 175–182.
Raz R, Miron D: Oral ciprofloxacin for treatment of infection following nail puncture wounds of the foot. Clinical Infectious Diseases 1995, 21: 194–195.
Labbe J-L, Bordes J-P, Fine X: An unusual surgical emergency: a knee joint wound caused by a needlefish. Journal of Arthroscopic and Related Surgery 1995, 11: 503–505.
Vilke GM, Honingford EA: Cervical spine epidural abscess in a patient with no predisposing risk factors. Annals of Emergency Surgery 1996, 27: 777–780.
Lewis RT: Necrotizing soft-tissue infections. Infectious Disease Clinics of North America 1992, 6: 693–703.
Hackner SM: Common infections of the skin: characteristics, causes, and cures. Postgraduate Medicine 1994, 96: 43–52.
Musher DM: Cutaneous and soft-tissue manifestations of sepsis due to gram-negative enteric bacilli. Reviews of Infectious Diseases 1980, 2: 854–866.
Kingston ME, Mackey D: Skin clues in the diagnosis of life-threatening infections. Reviews of Infectious Diseases 1986, 8: 1–11.
Musher DM: Cutaneous manifestations of bacterial sepsis. Hospital Practice 1989, 24: 71–98.
Bisno AL, Stevens DL: Streptococcal infections of skin and soft tissues. New England Journal of Medicine 1996, 334: 240–245.
Yong JM: Necrotizing fasciitis. Lancet 1994, 343: 1427–1428.
Greenwood D, Humphreys H, Emmerson AM: Necrotizing fasciitis. Lancet 1994, 344: 66–67.
Svensson LG, Brookstone AJ, Wellsted M: Necrotizing fasciitis in contused areas. Journal of Trauma 1985, 25: 260–262.
Fincher R-ME, Jackson MW, Fischer AQ:Citrobacter freundii: a newly reported cause of pyomyositis. American Journal of Medical Sciences 1990, 299: 331–333.
Falasca GF, Reginato AJ: The spectrum of myositis and rhabdomyolysis associated with bacterial infection. Journal of Rheumatology 1994, 21: 1932–1937.
Schaberg DR, Culver DH: Major trends in the microbial etiology of nosocomial infection. American Journal of Medicine 1991, 91, Supplement 3B: 72–75.
L'Ecuyer PB, Murphy D, Little JR, Fraser VJ: The epidemiology of chest and leg wound infections following cardiothoracic surgery. Clinical Infectious Diseases 1996, 22: 424–429.
Rudensky B, Lipschits M, Isaacsohn M, Sonnenblick M: Infected pressure sores: comparison of methods for bacterial identification. Southern Medical Journal 1992, 85: 901–903.
Crossley KB, Peterson PK: Infections in the elderly. Clinical Infectious Diseases 1996, 22: 209–215.
Heary RF, Vaccaro AR, Mesa JJ, Balderston RA: Thoracolumbar infections in penetrating injuries to the spine. Orthopedic Clinics of North America 1996, 27: 69–81.
Hendey GW, Votey SR: Injuries in restrained motor vehicle accident victims. Annals of Emergency Medicine 1994, 24: 77–84.
Hall JR, Reyes HM, Meiler JL, Loeff DS, Dembek RG: The new epidemic in children: penetrating injuries. Journal of Trauma 1995, 39: 487–491.
Haberal M, UÇar N, Bayraktar ü, öner Z, Bilgin N: Visceral injuries, wound infection and sepsis following electrical injuries. Burns 1996, 22: 158–161.
Falck G: Group A Streptococcal skin infections after indoor association football tournament. Lancet 1996, 347: 840–841.
Janda JM, Abbott SL: Human pathogens. In: Austin B, Altwegg M, Gosling PH, Joseph S (ed): The genusAeromonas. John Wiley, Chichester, UK, 1996, p. 151–170.
Mekisic AP, Wardill JR: Crocodile attacks in the Northern Territory of Australia. Medical Journal of Australia 1992, 157: 751–754.
Janda JM, Abbott SL: Infections associated with the genusEdwardsiella: the role ofEdwardsiella tarda in human disease. Clinical Infectious Diseases 1993, 17: 742–748.
Arai T, Ikejima N, Itoh T, Sakai S, Shimada T, Sakazaki R: A survey ofPlesiomonas shigelloides from aquatic environments, domestic animals, pets and humans. Journal of Hygiene 1980, 84: 203–211.
Brenden RA, Miller MA, Janda JM: Clinical disease spectrum and pathogenic factors associated withPlesiomonas shigelloides infections in humans. Reviews of Infectious Diseases 1988, 10: 303–316.
Hlady WG, Klontz KC: The epidemiology ofVibrio infections in Florida, 1981–1993. Journal of Infectious Diseases 1996, 173: 1176–1183.
McCallum WGB, Fromm RE Jr: Fish scale: an unusual foreign body. American Journal of Emergency Medicine 1995, 13: 419–420.
Murphey DK, Septimus EJ, Waagner DC: Catfish-related injury and infection: report of two cases and review of the literature. Clinical Infectious Diseases 1992, 14: 689–693.
Ratnam S, Hogan K, March SB, Butler RW: Whirlpoolassociated folliculitis caused byPseudomonas aeruginosa: report of an outbreak and review. Journal of Clinical Microbiology 1986, 23: 655–659.
Buck JD, Spotte S, Gadbaw JJ Jr: Bacteriology of the teeth from a great white shark: potential medical implications for shark bite victims. Journal of Clinical Microbiology 1984, 20: 849–851.
Kutarski PW: Outboard motor propeller injuries. Injury 1989, 20: 87–91.
Battistella FD, Wisner DH: Infections following trauma. In: Hoeprich PD, Jordan MC, Ronald AR (ed): Infectious diseases. Lippincott, Philadelphia, 1994, p. 1423–1428.
Hausman MR, Lisser SP: Hand infections. Orthopedic Clinics of North America 1992, 23: 171–185.
Moran GJ, Talan DA: Hand infections. Emergency Medicine Clinics of North America 1993, 11: 601–619.
Anger DM, Ledbetter BR, Stasikelis PJ, Calhoun JH: Injuries of the foot related to the use of lawn mowers. Journal of Bone and Joint Surgery 1995, 77A: 719–725.
Abbott SL, Janda JM:Enterobacter cancerogenus (“Enterobacter taylorae”) infections associated with severe trauma or crush injuries. American Journal of Clinical Pathology 1997, 107: 359–361.
Pien FD, Shrum S, Swenson JM, Hill BC, Thornsberry C, Farmer JJ III: Colonization of human wounds byEscherichia vulneris andEscherichia hermannii. Journal of Clinical Microbiology 1985, 22: 283–285.
Farmer JJ III, Davis BR, Hickman-Brenner FW, McWhorter A, Huntley-Carter GR, Asbury MA, Riddle C, Wathen-Grady HG, Elias C, Fanning GR, Steigerwalt AG, O'Hara CM, Morris GK, Smith PB, Brenner DJ: Biochemical identification of new species and biogroups ofEnterobacteriaceae isolated from clinical specimens. Journal of Clinical Microbiology 1985, 21: 46–76.
Wong MT, Dolan MJ: Significant infections due toBacillus species following abrasions associated with motor vehicle-related trauma. Clinical Infectious Diseases 1992, 15: 855–857.
Verville TD, Huycke MM, Greenfield RA, Fine DP, Kuhls TL, Slater LN:Rhodococcus equi infections of humans. Medicine 1994, 73: 119–132.
Dire DJ: Emergency management of dog and cat bite wounds. Emergency Medical Clinics of North America 1992, 10: 719–736.
Goldstein EJC: Infectious complications and therapy of bite wounds. Journal of the American Podiatric Medical Association 1989, 79: 486–491.
Goldstein EJC, Talon DA: Bite wounds. In: Hoeprich PD, Jordan MC, Ronald AR (ed): Infectious diseases, Lippincott, Philadelphia, 1994, p. 1420–1423.
Goldstein EJC, Nesbit CA, Citron DM: Comparative in vitro activities of azithromycin, Bay y 3118, levofloxacin, sparfloxacin, and eleven other oral antimicrobial agents against 194 aerobic and anaerobic bite wound isolates. Antimicrobial Agents and Chemotherapy 1995, 39: 1097–1100.
Brook I: Human and animal bite infections. Journal of Family Practice 1989, 28: 713–718.
Anderson C: Animal bites. Postgraduate Medicine 1992, 92: 134–149.
Goldstein EJC: Bite wounds and infection. Clinical Infectious Diseases 1992, 14: 633–638.
Talan DA, Goldstein EJC, Staatz D, Overturf GD:Staphylococcus intermedius: clinical presentation of a newly recognized human dog bite pathogen. Annals of Emergency Medicine 1988, 17: 1123.
Andersen BM, Steigerwalt AG, O'Connor SP, Hollis DG, Weyant RS, Weaver RE, Brenner DJ:Neisseria weaveri sp. nov., formerly CDC M-5, a gram-negative bacterium associated with dog bite wounds. Journal of Clinical Microbiology 1993, 31: 2456–2466.
Baker MD, Moore SE: Human bites in children: a six-year experience. American Journal of Diseases of Children 1987, 141: 1285–1290.
Hagan M, Goldstein E: Bites from pet animals. Hospital Practice 1993, 28: 79–86.
Leung AKC, Robson WLM: Human bites in children. Pediatric Emergency Care 1992, 8: 255–257.
Barnham M: Pig bite injuries and infection: report of seven human cases. Epidemiology and Infection 1988, 101: 641–645.
Goldstein EJC, Citron DM, Merkin TE, Pickett MJ: Recovery of an unusualFlavobacterium group llb-like isolate from a hand infection following a pig bite. Journal of Clinical Microbiology 1990, 28: 1079–1081.
Morgan MS: Treatment of pig bites. Lancet 1996, 348: 1246.
Sachs MK: LymphocutaneousNocardia brasiliensis infection acquired from a cat scratch: case report and review. Clinical Infectious Diseases 1992, 15: 710–711.
Clark RF, Selden BS, Furbee B: The incidence of wound infection following crotalid envenomation. Journal of Emergency Medicine 1993, 11: 583–586.
Wingert WA, Chan L: Rattlesnake bites in southern California and rationale for recommended treatment. Western Journal of Medicine 1988, 148: 37–44.
Berkowitz FE, Jacobs DWC: Fatal case of brain abscess caused by rooster pecking. Pediatric Infectious Disease Journal 1987, 6: 941–942.
Reyes FA: Infections secondary to intravenous drug abuse. Hand Clinics 1989, 5: 629–633.
Miskew DBW, Lorenz MA, Pearson RL, Pankovich AM:Pseudomonas aeruginosa bone and joint infection in drug abusers. Journal of Bone and Joint Surgery 1983, 65A: 829–832.
Mechem CC, Walter FG: Wound botulism. Veterinary and Human Toxicology 1994, 36: 233–237.
Burningham MD, Walter FG, Mechem C, Haber J, Ekins BR: Wound botulism. Annals of Emergency Medicine 1994, 24: 1104–1107.
Anonymous. Wound botulism — California. Morbidity and Mortality Weekly Report 1995, 44: 889–892.
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Janda, J.M., Abbott, S.L. & Brenden, R.A. Overview of the etiology of wound infections with particular emphasis on community-acquired illnesses. Eur. J. Clin. Microbiol. Infect. Dis. 16, 189–201 (1997). https://doi.org/10.1007/BF01709581
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DOI: https://doi.org/10.1007/BF01709581