Evidence map›Paper›PMID 29667040›Full record

ArticleInfection2018

Management of superficial and deep-seated Staphylococcus aureus skin and soft tissue infections in sub-Saharan Africa: a post hoc analysis of the StaphNet cohort.

Abraham Alabi, Theckla Kazimoto, Marthe Lebughe, Delfino Vubil, Patrick Phaku, Inacio Mandomando, Winfried V Kern, Salim Abdulla, Alexander Mellmann, Lena Peitzmann and 6 more

Open access · greenAbstract read
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In one paragraph

Article in Infection, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.4field-weighted citation impact, top 38% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 13 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 7 institutions in 6 countries.

Abraham AlabiCentre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon.ORCID http://orcid.org/0000-0003-0324-6420
Theckla KazimotoIfakara Health Institute (IHI), Dar es Salaam, Tanzania.ORCID http://orcid.org/0000-0001-7456-654X
Marthe LebugheInstitut National de Recherche Bio-Médicale (INRB), Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.
Delfino VubilManhiça Health Research Center, Manhiça, Maputo, Mozambique.ORCID http://orcid.org/0000-0001-9139-5594
Patrick PhakuInstitut National de Recherche Bio-Médicale (INRB), Université de Kinshasa, Kinshasa, Democratic Republic of the Congo.
Inacio MandomandoManhiça Health Research Center, Manhiça, Maputo, Mozambique.ORCID http://orcid.org/0000-0002-1078-2187
Winfried V KernDivision of Infectious Diseases, Department of Medicine II, Medical Center, University of Freiburg Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.ORCID http://orcid.org/0000-0003-2550-358X
Salim AbdullaIfakara Health Institute (IHI), Dar es Salaam, Tanzania.ORCID http://orcid.org/0000-0001-5071-5205
Alexander MellmannInstitute of Hygiene, University Hospital Münster, Münster, Germany.ORCID http://orcid.org/0000-0002-0649-5185
Lena PeitzmannInstitute of Hygiene, University Hospital Münster, Münster, Germany.
Markus BischoffInstitute of Medical Microbiology and Hygiene, Saarland University, Homburg, Germany.ORCID http://orcid.org/0000-0001-6734-2732
Georg PetersInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany.
Mathias HerrmannInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany.
Martin P GrobuschCentre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, Lambaréné, Gabon.
Frieder SchaumburgInstitute of Medical Microbiology, University Hospital Münster, Münster, Germany. frieder.schaumburg@ukmuenster.de.ORCID http://orcid.org/0000-0002-9168-9290
Siegbert RiegDivision of Infectious Diseases, Department of Medicine II, Medical Center, University of Freiburg Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
University Hospital Münster · DEAlbert Schweitzer Hospital · GAIfakara Health Institute · TZManhiça Health Research Centre · MZUniversity of Freiburg · DEUniversity of Kinshasa · CDInstitute of Medical Microbiology and Hygiene · DE

Funding

Deutsche Forschungsgemeinschaft HE 1850/11-1Deutsche Forschungsgemeinschaft KE 700/3-1Deutsche Forschungsgemeinschaft ME 3205/4-1Deutsche Forschungsgemeinschaft PE 296/6-1
6 · The paper itself

Abstract

purposeThe incidence of Staphylococcus aureus skin and soft tissue infection (SSTI) is high in sub-Saharan Africa. This is fueled by a high prevalence of Panton-Valentine leukocidin (PVL), which can be associated with necrotizing disease. The aim was to describe the clinical presentation and the treatment of SSTI in the African setting and to identify challenges in the management.

methodsPatients (n = 319) were recruited in DR Congo (n = 56, 17.6%), Gabon (n = 89, 27.9%), Mozambique (n = 79, 24.8%) and Tanzania (n = 95, 29.8%) during the prospective observational StaphNet cohort study (2010-2015). A physician recorded the clinical management in standardized questionnaires and stratified the entity of SSTI into superficial (sSSTI) or deep-seated (dSSTI). Selected virulence factors (PVL, β hemolysin) and multilocus sequence types (MLST) were extracted from whole genome sequencing data.

resultsThere were 220/319 (69%) sSSTI and 99/319 (31%) dSSTI. Compared to sSSTI, patients with dSSTI were more often hospitalized (13.2 vs. 23.5%, p = 0.03), HIV-positive (7.6 vs. 15.9%, p = 0.11), and required more often incision and drainage (I&D, 45.5 vs. 76.5%, p = 0.04). The proportion of an adequate antimicrobial therapy increased marginally from day 1 (empirical therapy) to day 3 (definite therapy), for sSSTI (70.7 to 72.4%) and dSSTI (55.4 to 58.9%). PVL was a risk factor for I&D (OR = 1.7, p = 0.02) and associated with MLST clonal complex CC121 (OR = 2.7, p < 0.001).

conclusionAppropriate antimicrobial agents and surgical services to perform I&D were available for the majority of patients. Results from susceptibility testing should be considered more efficiently in the selection of antimicrobial therapy.

Indexed as

Soft Tissue InfectionsStaphylococcal InfectionsAdolescentAdultAfrica South of the SaharaAgedAged, 80 and overAnti-Bacterial AgentsChildChild, PreschoolCohort StudiesFemaleHumansInfantInfant, NewbornMaleAnti-Bacterial AgentsManagementMicrobiologySkin and soft tissue infectionStaphylococcus aureusSub-Saharan Africa

Identifiers

PMID29667040
OpenAlexW2801610040

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.