Skin and soft-tissue infections: impact of resistant gram-positive bacteria

Surgical site infections remain significant causes of postoperative morbidity and mortality despite an improved understanding of risk factors and an increasing armamentarium of antimicrobial agents. The overall rates of surgical site infections have been slowly decreasing, but the proportion of infections with gram-positive bacteria continues to increase, and drug-resistant species continue to become more prevalent. Although new antibiotic classes have efficacy against such organisms, these agents are only short-term solutions to the problem of multiple-drug resistance. Surgeons must focus on prevention of infections by appropriately using antibiotics, emphasizing principles of infection control, and understanding nontraditional measures that may decrease infection risk. (C) 2003 Excerpta Medica, Inc. All rights reserved.