What organisms cause multiple skin abscesses?

From the Guidelines

Multiple skin abscesses are most commonly caused by Staphylococcus aureus, particularly methicillin-resistant Staphylococcus aureus (MRSA), as well as other bacteria like Streptococcus species, Pseudomonas aeruginosa, and anaerobic bacteria like Bacteroides. The management of multiple skin abscesses typically involves incision and drainage of the abscesses, combined with appropriate antimicrobial therapy. According to the most recent guidelines, for mild to moderate infections, oral antibiotics like trimethoprim-sulfamethoxazole, doxycycline, or clindamycin are often effective against MRSA 1.

Key Points to Consider

• The primary cause of multiple skin abscesses is bacterial, with MRSA being a prevalent cause in community-acquired infections.
• Incision and drainage are the primary treatments for simple abscesses, with antibiotics being considered for more complex cases or when there are signs of systemic infection.
• For patients with recurrent abscesses, consideration should be given to decolonization protocols, including chlorhexidine washes and intranasal mupirocin, to reduce the risk of further infections 1.
• In cases of severe infections or when MRSA is suspected, intravenous antibiotics such as vancomycin, linezolid, or daptomycin may be necessary.
• Proper hygiene practices, including regular handwashing and not sharing personal items, are crucial in preventing the spread of these organisms.

Treatment Approach

• Incision and drainage are the cornerstone of treatment for skin abscesses.
• Antibiotic therapy should be guided by the severity of the infection, the presence of systemic signs, and the suspected or confirmed causative organism.
• For mild to moderate infections, oral antibiotics such as trimethoprim-sulfamethoxazole, doxycycline, or clindamycin are recommended 1.
• In severe cases or when MRSA is suspected, intravenous antibiotics like vancomycin, linezolid, or daptomycin should be considered.

Prevention and Public Health

• Preventing the spread of MRSA and other causative organisms of skin abscesses involves practicing good hygiene, including regular handwashing and not sharing personal items.
• In healthcare settings, adherence to infection control practices is critical to prevent the spread of these organisms.

Given the potential for morbidity and mortality associated with untreated or inadequately treated skin abscesses, particularly those caused by MRSA, prompt and appropriate management is crucial. This includes not only the treatment of the current infection but also consideration of preventive measures to reduce the risk of recurrence and transmission to others 1.

From the FDA Drug Label

Clindamycin is also indicated in the treatment of serious infections due to susceptible strains of streptococci, pneumococci, and staphylococci Serious skin and soft tissue infections; septicemia; Streptococci: Serious respiratory tract infections; serious skin and soft tissue infections. Staphylococci: Serious respiratory tract infections; serious skin and soft tissue infections.

The organisms that cause multiple skin abscesses include Staphylococci and Streptococci 2.

• Staphylococci can cause serious skin and soft tissue infections, including skin abscesses.
• Streptococci can also cause serious skin and soft tissue infections, including skin abscesses. Additionally, Anaerobes can cause serious skin and soft tissue infections, which may include skin abscesses 2.

From the Research

Organisms Causing Multiple Skin Abscesses

• Methicillin-resistant Staphylococcus aureus (MRSA) is a prominent cause of community-acquired infections, including multiple skin abscesses 3, 4, 5, 6, 7
• MRSA is a well-known nosocomial pathogen that has emerged as a major cause of skin and soft tissue infections (SSTI) in the community 3, 5
• Other organisms, such as methicillin-sensitive Staphylococcus aureus and group A Streptococcus, can also cause skin abscesses, but MRSA is a more common cause of multiple skin abscesses 4, 6, 7

Clinical Presentation and Treatment

• Cutaneous abscesses are the most common presentation of cutaneous MRSA infection 3
• Definitive treatment of MRSA skin abscesses typically consists of incision and drainage in combination with antimicrobial therapy 3, 5, 6
• Antibiotics such as vancomycin, trimethoprim/sulfamethoxazole, and linezolid are effective against MRSA and can be used to treat skin abscesses 3, 4, 5, 6, 7

Antibiotic Treatment and Outcomes

• Empiric treatment of CA-MRSA skin abscesses with antibiotics active against MRSA is associated with improved clinical outcomes 5, 6, 7
• Trimethoprim-sulfamethoxazole is a commonly used antibiotic for treating MRSA skin abscesses and has been shown to be effective in reducing failure and recurrence rates 4, 6, 7
• The duration of antibiotic treatment can impact outcomes, with longer courses of treatment (e.g. 10 days) potentially reducing the risk of treatment failure and recurrence 6