ABSTRACT
Skin harbors a milieu of microbial flora since birth, which is putatively known to exhibit mutualistic relationships with the host by conferring protection to the host from pathogenic attack and acquiring a suitable niche and nutrients for survival from the host in return. Dermatological infections associated with bacteria ranges from mild superficial infections such as folliculitis to deep-seated cellulitis and even life-threatening necrotizing fasciitis. Mild skin infections are easy to treat with prevailing antibiotic treatments. However, the recovery rate of certain severe skin infections prolongs and even increases the rate of morbidity and mortality, as it remains intractable to treat. This scenario exists as a result of emergence of multidrug-resistant bacteria with the armor of sophisticated biofilm and other virulent determinants, which help it to evade host immune system and antibiotic treatments. Additionally, recent findings suggest the pathogenic role of commensals in skin infections. This notion mandates the deep insights into the virulence determinants of pathogens in infections, their antibiotic resistant pattern, role of commensals in health and disease state, and the relationship between host and commensal and commensal and pathogen for reframing the treatment strategies to manage the intractable infections. This chapter focuses on different skin and skin-structured infections, their epidemiology, diagnosis, and treatment options together with our understanding of role of virulent determinants of bacteria causing skin infections.
