Epidemiology and prevention of skin and soft tissue infections.

Staphylococcus aureus and Streptococcus pyogenes remain the 2 major organisms responsible for most common skin and soft tissue infections. While methicillin-resistant S aureus (MRSA) typically is considered a hospital-acquired organism, outbreaks of community-acquired MRSA are being reported. Simple interventions can reduce the spread of this infection. Erysipelas is a streptococcal syndrome with high morbidity. The epidemiology has changed, with an increasing number of cases involving the lower extremities. Risk factors for erysipelas can be identified, which allow clinicians to target patients at high risk for recurrent disease. Although staphylococci and streptococci are the predominant cutaneous pathogens, enterococci and gram-negative organisms account for a significant proportion of skin infections.