Cutaneous Bacterial Infections - Types, Causes, Symptoms, Diagnosis, and Treatment

Introduction

Bacteria (typically Staphylococcal or Streptococcal) can invade healthy skin or a skin barrier that has been weakened (such as skin affected by atopic dermatitis - itchy skin inflammation or surgical incision sites).

The skin serves as the body's initial line of defense against the elements. When this barrier of defense is breached, a local or systemic reaction is set in motion. Skin-invading microbes may originate from the external environment or the typical skin microbiome.

Who Is Vulnerable to Bacterial Skin Infections?

Skin infections caused by bacteria frequently require emergency room visits. Over 65-year-old people and young children are more frequently impacted than other age groups. The World Health Organization (WHO) noted in 2005 that children from developing nations in sub-Saharan Africa have a high prevalence of skin conditions.

Men made up 60 to 70 percent of all cellulitis cases in one North American study, suggesting that gender may potentially be important.

Diabetes, vascular dysfunction (improper function of cells of the blood vessels), and immune-compromising diseases (such as chemotherapy patients with neutropenia) can increase vulnerability to bacterial skin infections. Skin infections are common in hospitalized individuals and frequently make the hospital stay more difficult.

Why Do Bacterial Skin Infections Occur?

Bacteria can infiltrate through the skin's surface and cause bacterial skin infections. For instance, a cut or wound could cause this.

Additionally, surgical incisions might allow bacteria to penetrate the skin. SSTIs (skin and soft tissue infections) are, therefore, the most frequent infections connected with healthcare in patients having surgery.

What Kinds of Bacterial Skin Infections Are There?

Skin infections caused by bacteria can range from minor surface infections to serious necrotizing illnesses, and they can damage the skin, underlying subcutaneous tissue, or muscles.

Skin or soft tissue infections, or SSTIs, are infections. These were previously classified by the Food and Drug Administration (FDA) as "complicated SSTI" and "uncomplicated SSTI." Bacterial skin infections are now classified by the FDA as SSTI or ABSSSI (acute bacterial skin and skin structure infections).

SSTI:

• Carbuncles (a collection of boils that together constitute an infected region).

• Folliculitis (skin infection involving hair follicles).

• Ecthyma (a skin infection occurring in the deeper area of the skin).

• Erythrasma (a Corynebacterial skin infection).

• Furuncles (boil).

• Impetigo (superficial skin infection).

• Lymphadenitis (infection and inflammation of lymph nodes).

• Small cutaneous abscess.

ABSSSI: A more complicated type of bacterial skin infection. According to a 2013 FDA announcement, ABSSSI is defined as acute bacterial skin and skin structure infections and some examples are as follows:

• Cellulitis (a serious bacterial infection of the skin).

• Erysipelas (infection of the skin and underlying tissue).

• Infection of a wound.

• A significant, at least 75 square centimeter-sized cutaneous abscess.

What Are the Most Common Bacterial Skin Infections and Symptoms?

The most common bacterial skin infections are

1. Erysipelas: A cutaneous infection that beta-hemolytic streptococci most frequently cause. Usually, the face or legs are affected by this disease. Occasionally, it can affect a cut or wounded area of the skin. There are numerous cases of fever and flu-like symptoms. Some signs could be:

• Elevated, red, and shiny rash.

• Little blisters.

• Swelling and pain in the lymph nodes.

2. Erythrasma: A superficial bacterial skin infection that is particularly prevalent in tropical climates. Corynebacterium minutissimum bacteria are to blame for this. Adults who are obese and diabetics are the groups most affected by this illness. It frequently appears on bodily regions where skin touches the skin. This encompasses the area in the groin and under the breast. Uneven pink patches that develop into brown scales may be a symptom.

3. Impetigo: An infection of the skin brought on by a Staphylococcal or Streptococcal infection. Blisters or pustules that are filled with pus are symptoms. Pea-sized to huge rings-sized blisters are common. There are frequently yellowish scabs and seeping honey-colored fluids. Impetigo typically appears on the arms, legs, or face. Kids most frequently experience it. It spreads quickly. However, symptoms frequently do not impact the entire body.

4. Paronychia: An infection of the skin around a toenail or fingernail. This infection may result from a skin breach brought on by a hangnail, manicure, biting of the fingernails, or another long-lasting (chronic) irritation. Some signs could be:

• Pain.

• Abscess with pus.

5. Cellulitis: This is a severe skin infection brought on by germs. Usually, the arms and legs are affected. Typical signs include:

• Skin that is swollen or red.

• Tenderness.

• Warm skin.

• Pain.

• Bruising.

• Blisters.

• Fever.

• Headache.

• Chills.

• Weakness.

• Red streaks from the cellulitis's original place.

6. Folliculitis: It is a hair follicle infection or inflammation. It has a base of red, swollen hair follicles that resembles tiny pimples. They might be pus-filled lumps. Also possible are:

• Itchy.

• Painful.

• Red.

• Swollen.

7. Staphylococcal Scaled Skin Syndrome: This skin infection is really dangerous. Over a significant portion of the body, the infection results in skin peeling. Some symptoms include:

• Irritability.

• Tiredness.

• Fever.

• Skin color that is red.

• Blisters that are fluid-filled and rupture readily, leaving behind moist skin that quickly ages and becomes uncomfortable.

• The outermost layer of skin could come off in large sheets.

How Are Skin Infections Caused by Bacteria Diagnosed?

Clinical examinations are frequently used to identify bacterial skin infections, despite certain laboratory tests, such as:

• Full Blood Count: A bacterial illness frequently increases neutrophil and white cell counts.

• C-reactive Protein (CRP): Increased >50 in serious bacterial infections (notice that symptoms may not appear for up to 24 hours after CRP rises).

• Procalcitonin: It is a blood test marker for bacterially-induced generalized sepsis.

• Blood Test: Fever (over 38°C) requires a blood test.

• Culture Sensitivity Test: Skin lesion (s) sent for swabbing for microscopy, culture, and sensitivity.

How Can Bacterial Skin Infections Be Avoided?

• Regular hand washing, particularly before and after handling skin that has been damaged.

• General lifestyle factors (such as managing weight if overweight or underweight, quitting smoking, and consuming less alcohol) can enhance overall health and immunological function.

• Improving the management of other medical issues, such as diabetes control.

• Maintaining the skin barrier (for instance, by managing atopic dermatitis properly and avoiding skin irritants or allergens).

How Are Bacterial Skin Infections Treated?

Small bacterial infections frequently go away on their own. Topical antiseptics are frequently used as an option for mild infections because the first-line use of topical antibiotics, such as Fusidic acid, is generally discouraged due to rising antibiotic resistance. Antibiotics used orally, intravenously (through the vein), or even intramuscularly (through the muscle) are used to treat more severe or persistent bacterial infections.

• Before starting antibiotics, it is best to collect samples (such as swabs or blood cultures) to identify the organism causing the infection.

• Do not postpone treatment with a broad-spectrum antibiotic if the infection is significant (such as probable meningococcal disease).

• Change to a suitable narrow-spectrum antibiotic as soon as culture and sensitivities are known.

• If an antibiotic is not necessary or is not likely to be helpful, such as if the infection is viral in nature, it should not be provided. Skin problems and gastrointestinal side effects are examples of adverse responses.

• Stewardship of antibiotics (measurement and improvement of patient and physician usage of antibiotics) is another crucial factor.

Conclusion

Skin infections brought on by bacteria are known as cutaneous bacterial infections. They can range from minor infections to more serious, deeper ones. These infections can be successfully treated with the right medical intervention and preventive measures, limiting discomfort and repercussions. It is critical to get medical help if it appears that they could have a bacterial infection of the skin for a precise diagnosis and individualized treatment plan.