Lipsky Benjamin A, Silverman Michael H, Joseph Warren S
University of Oxford, United Kingdom.
BioStrategics Consulting Ltd, Marblehead, Massachusetts.
Open Forum Infect Dis. 2016 Dec 7;4(1):ofw255. doi: 10.1093/ofid/ofw255. eCollection 2017 Winter.
Schemes for classifying skin and soft tissue infections (SSTIs) pose limitations for clinicians and regulatory agencies. Diabetic foot infections (DFIs) are a subset of SSTIs. We developed and are proposing a classification to harmonize current schemes for SSTIs and DFIs. Existing schemes for classifying SSTIs are limited in both their usefulness to clinicians and to regulatory agencies. The guidelines on SSTI from the Infectious Diseases Society of America (IDSA) and the guidance from the US Food and Drug Administration do not adequately address many types of wound infections. However, guidelines developed by the IDSA for DFIs provide a classification scheme that has been validated and widely used. Diabetic foot infections are similar to SSTIs in pathophysiology, microbiology, and treatment and can be seen as a subset of SSTI. Thus, based on the documents noted above, and our review of the literature, we have developed a proposed classification scheme for SSTI that harmonizes well with the DFI classification. We believe this new scheme will assist clinicians in classifying most wound infections and potentially aid regulatory agencies in testing and approving new antimicrobials for these infections.
皮肤和软组织感染（SSTIs）的分类方案给临床医生和监管机构带来了局限性。糖尿病足感染（DFIs）是SSTIs的一个子集。我们制定并提议采用一种分类方法，以协调当前SSTIs和DFIs的分类方案。现有的SSTIs分类方案在对临床医生和监管机构的实用性方面都存在局限。美国传染病学会（IDSA）发布的SSTI指南以及美国食品药品监督管理局的指导意见都未能充分涵盖多种类型的伤口感染。然而，IDSA制定的DFIs指南提供了一个经过验证且被广泛使用的分类方案。糖尿病足感染在病理生理学、微生物学和治疗方面与SSTIs相似，可被视为SSTI的一个子集。因此，基于上述文件以及我们对文献的回顾，我们制定了一个提议的SSTI分类方案，该方案与DFI分类高度协调。我们相信这个新方案将有助于临床医生对大多数伤口感染进行分类，并可能有助于监管机构对针对这些感染的新型抗菌药物进行测试和审批。
