Falcone Marco, Concia Ercole, Giusti Massimo, Mazzone Antonino, Santini Claudio, Stefani Stefania, Violi Francesco
Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Policlinico Umberto I, Viale Dell'Università 37, 00161, Rome, Italy.
Department of Pathology, University of Verona, Verona, Italy.
Intern Emerg Med. 2016 Aug;11(5):637-48. doi: 10.1007/s11739-016-1450-6. Epub 2016 Apr 15.
Skin and soft tissue infections (SSTIs) are a common cause of hospital admission among elderly patients, and traditionally have been divided into complicated and uncomplicated SSTIs. In 2010, the FDA provided a new classification of these infections, and a new category of disease, named acute bacterial skin and skin structure infections (ABSSSIs), has been proposed as an independent clinical entity. ABSSSIs include three entities: cellulitis and erysipelas, wound infections, and major cutaneous abscesses This paper revises the epidemiology of SSTIs and ABSSSIs with regard to etiologies, diagnostic techniques, and clinical presentation in the hospital settings. Particular attention is owed to frail patients with multiple comorbidities and underlying significant disease states, hospitalized on internal medicine wards or residing in nursing homes, who appear to be at increased risk of infection due to multi-drug resistant pathogens and treatment failures. Management of ABSSSIs and SSTIs, including evaluation of the hemodynamic state, surgical intervention and treatment with appropriate antibiotic therapy are extensively discussed.
皮肤及软组织感染（SSTIs）是老年患者住院的常见原因，传统上分为复杂性和非复杂性SSTIs。2010年，美国食品药品监督管理局（FDA）对这些感染进行了新的分类，并提出了一种名为急性细菌性皮肤和皮肤结构感染（ABSSSIs）的新疾病类别作为一个独立的临床实体。ABSSSIs包括三种情况：蜂窝织炎和丹毒、伤口感染以及主要的皮肤脓肿。本文就医院环境中SSTIs和ABSSSIs在病因、诊断技术和临床表现方面的流行病学进行了修订。尤其要关注患有多种合并症和潜在重大疾病的体弱患者，这些患者在内科病房住院或住在养老院，由于多重耐药病原体和治疗失败，他们似乎感染风险增加。本文还广泛讨论了ABSSSIs和SSTIs的管理，包括血流动力学状态评估、手术干预和适当的抗生素治疗。
