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Skin as a Source for Hospital Infection

Published online by Cambridge University Press:  02 January 2015

William Noble*
Affiliation:
Institute of Dermatology, St. John's Hospital for Diseases of the Skin, London, England
*
Department of Microbiology, Institute of Dermatology, St. John's Hospital for Diseases of the Skin-Homerton Grove, London, E9 6BX, England

Extract

The skin is itself the site of infection by many different bacteria. Dermatologists may see primary skin infection due to Staphylococcus aureus, beta hemolytic streptococci and a host of less common pathogens including gonococci, mycobacteria and even enterobacteriaceae, or secondary infection which is mostly staphylococcal in eczema or weighted toward Proteus and Pseudomonas in venous stasis ulcers. Geriatricians see a mixed microbial flora in decubitus ulcers while those who insert plastic prostheses, intravenous or abdominal catheters can expect infection with coagulase-negative or positive cocci.

The skin also forms a natural reservoir of organisms available to infect a variety of patients and it is with the skin as a reservoir that this article is concerned. The normal flora of the skin in healthy subjects is composed chiefly of coagulase-negative cocci and coryneforms with gram-negative bacilli chiefly, but not entirely, represented by Acinetobacter. Patients admitted to the hospital who are severely ill may become more heavily colonized by gram-negative bacilli while frank skin lesions constitute a more obvious source of potential pathogens.

Type
Research Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1986

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