Clinical and Bacteriological Aspects of Pyoderma

Pyoderma is one of the commonest clinical conditions encountered in dermatological practice.[1] Primary pyodermas are impetigo, follicultis, furuncle, carbuncle, ecthyma, erthyrasma, and sycosis barbae. Secondary pyodermas constitute tropic ulcer, infected pemphigus, infected contact dermatitis, infected scabies, and various other dermatoses infected with organisms. Various factors like poverty, malnutrition, overcrowding, and poor hygiene have been stated to be responsible for its higher incidence in the lower socio-economic class. Climatic conditions also play a major role.[2] Changing trends are being noted in the etiological aspects of primary pyoderma, and the problem of emergence of drug resistance strains is an even increasing one. Most common organism usually isolated in pyoderma is Staphyloccus aureus, which may be either methicilllin-sensitive (MSSA) or methicilllin-resistant (MRSA). MRSA is an important health care associated pathogen. Many of these isolates are becoming multidrug resistant. All β-lactams including carbapenams and high-end cephalosporins, piperacillin, tazobactum etc. are ineffective against MRSA. Knowledge of prevalence of MRSA and their current anti-microbial profile becomes necessary in the selection of appropriate empirical treatment of these infections.[3] Here, we report the clinical and bacteriological aspects of the pyodermas to guide for the selection of appropriate antibiotics and to prevent the emergence of resistant organisms. We found that the incidence of impetigo was maximum among pyoderma. The primary pyoderma cases were maximum in the age group of < 10 years, and prevalence rate was higher in male patients. Among the various diseases, scabies was found to be the commonest to be associated with primary pyoderma. Most common isolated organism was Staphylococcus aureus. Pyodermas are a common cause of skin infection in children and are associated with many multidrug-resistant organisms such as MRSA. A correct anti-microbial policy based on the knowledge of resistance patterns of the commonly isolated organisms is mandatory to prevent unnecessary medication and further emergence of drug-resistant organisms.