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Cutaneous Serratia marcescens infections in Korea: A retrospective analysis of 13 patients

Authors
 Jimyung SEO  ;  Dongyun SHIN  ;  Sang Ho OH  ;  Ju Hee LEE  ;  Kee Yang CHUNG  ;  Min-Geol LEE  ;  Dae Suk KIM 
Citation
 JOURNAL OF DERMATOLOGY, Vol.43(2) : 149-155, 2015 
Journal Title
 JOURNAL OF DERMATOLOGY 
ISSN
 0385-2407 
Issue Date
2015
MeSH
Adult ; Aged ; Aged, 80 and over ; Drug Resistance, Multiple, Bacterial ; Female ; Humans ; Male ; Middle Aged ; Republic of Korea ; Retrospective Studies ; Serratia Infections/diagnosis ; Serratia Infections/drug therapy ; Serratia Infections/microbiology* ; Serratia marcescens*/drug effects ; Serratia marcescens*/isolation & purification ; Skin Diseases, Bacterial/diagnosis ; Skin Diseases, Bacterial/drug therapy ; Skin Diseases, Bacterial/microbiology* ; Young Adult
Keywords
Serratia marcescens ; antimicrobial resistance ; cutaneous infection ; host immune status ; risk factors
Abstract
Serratia marcescens is a Gram-negative bacillus belonging to the Enterobacteriaceae family. Because of increasing reports of antimicrobial resistance, this bacterium has received considerable attention and has emerged as an important pathogen. In order to reveal clinical and microbiological characteristics of S. marcescens cutaneous infection and to suggest appropriate antibiotic treatment, we retrospectively analyzed 17 strains isolated from wound swabs of Korean patients between November 2005 and March 2014. A total of 13 patients (five men and eight women) were included in our study, with a mean age of 46.3 years (range, 21-82). Based on medical history, seven patients were classified as immunocompromised. Prior predisposing factors for infections were noted in 12 patients, including pre-existing leg ulcers or dermatitis (5/13), preceding cancer surgeries (2/13), plastic surgeries and filler injection (2/13), traumas (2/13) and medical procedures following cutaneous abscess (1/13). Cutaneous infections showed various clinical presentations, including spontaneous dermal abscess, fingernail change, painful nodules and papular erosions. We found that third- and fourth-generation cephalosporins, gentamicin, levofloxacin and meropenem appeared active against all 17 strains in vitro. Clinically, all patients treated with empirical first-generation cephalosporin showed treatment resistance, and oral quinolone monotherapy was the most preferred antibiotic regimen without treatment failure, with an average treatment duration of 25 days (range, 14-42). This study demonstrates the various clinical presentations and treatment responses for cutaneous S. marcescens infection. Moreover, we suggest that initial antibiotic coverage should be broad enough to account for multidrug resistance in this rare pathogen.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/1346-8138.13059/abstract
DOI
10.1111/1346-8138.13059
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Dermatology (피부과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Suk(김대석)
Seo, Jimyung(서지명)
Shin, Dong Yun(신동윤)
Oh, Sang Ho(오상호) ORCID logo https://orcid.org/0000-0002-4477-1400
Lee, Min Geol(이민걸) ORCID logo https://orcid.org/0000-0001-7040-5335
Lee, Ju Hee(이주희) ORCID logo https://orcid.org/0000-0002-1739-5956
Chung, Kee Yang(정기양) ORCID logo https://orcid.org/0000-0003-3257-0297
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/157133
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