Skin and soft tissue infections (SSTI) are a source of significant illness and accounted for over 2 million visits to emergency room departments in the United States in 2004. While most infections are minor and do not require hospitalization, some can be life-threatening—particularly for people living with HIV.
The majority of outpatient SSTI are caused by gram-positive bacteria, typically Streptococcus and Staphylococcus species. In the past, SSTI caused by these organisms were reliably treated with beta-lactam antibiotics (penicillins and cephalosporins). Resistance to these antibiotics was uncommon and was typically only seen in infections caused by Staphylococcus aureus that had acquired a gene conferring resistance to all beta-lactams, including the drug methicillin. These resistant infections typically only occurred in hospitalized or recently-hospitalized individuals.
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