{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T16:21:36Z","timestamp":1792254096334,"version":"4.4.0"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"11","funder":[{"name":"Centers for Disease Control and Prevention (cooperative agreement","award":["U01\/CI000353-0"],"award-info":[{"award-number":["U01\/CI000353-0"]}]},{"name":")"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Background. \u2003The cause of cellulitis is unclear. Streptococcus pyogenes, and to a lesser extent, Staphylococcus aureus, are presumed pathogens.<\/jats:p>\n               <jats:p>Methods. \u2003We conducted a study of adults with acute cellulitis without drainage presenting to a US emergency department research network. Skin biopsy specimens were taken from the infected site and a comparable uninfected site on the opposite side of the body. Microbiology was evaluated using quantitative polymerase chain reaction (PCR), pyrosequencing, and standard culture techniques. To determine the cause, the prevalence and quantity of bacterial species at the infected and uninfected sites were compared.<\/jats:p>\n               <jats:p>Results. \u2003Among 50 subjects with biopsy specimens from infected and uninfected sites, culture rarely identified a bacterium. Among 49 subjects with paired specimens from infected and uninfected sites tested with PCR, methicillin-susceptible S. aureus was identified in 20 (41%) and 17 (34%), respectively. Pyrosequencing identified abundant atypical bacteria in addition to streptococci and staphylococci. Among 49 subjects with paired specimens tested by pyrosequencing, S. aureus was identified from 11 (22%) and 15 (31%) and streptococci from 15 (31%) and 20 (41%) of the specimens, respectively. Methicillin-resistant S. aureus was not found by culture or PCR, and S. pyogenes was not identified by any technique.<\/jats:p>\n               <jats:p>Conclusions. \u2003The bacterial cause of cellulitis cannot be determined by comparing the prevalence and quantity of pathogens from infected and uninfected skin biopsy specimens using current molecular techniques. Methicillin-susceptible S. aureus was detected but not methicillin-resistant S. aureus or S. pyogenes from cellulitis tissue specimens. For now, optimal treatment will need to be guided by clinical trials. Noninfectious causes should also be explored.<\/jats:p>","DOI":"10.1093\/cid\/civ655","type":"journal-article","created":{"date-parts":[[2015,8,4]],"date-time":"2015-08-04T00:29:52Z","timestamp":1438648192000},"page":"1679-1687","source":"Crossref","is-referenced-by-count":26,"title":["Inability of Polymerase Chain Reaction, Pyrosequencing, and Culture of Infected and Uninfected Site Skin Biopsy Specimens to Identify the Cause of Cellulitis"],"prefix":"10.1093","volume":"61","author":[{"given":"Jonathan G.","family":"Crisp","sequence":"first","affiliation":[{"name":"1 Departments of Emergency Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhjit S.","family":"Takhar","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital, Harvard Medical School, 4 Departments of Emergency Medicine and Medicine, Division of Infectious Diseases , Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Moran","sequence":"additional","affiliation":[{"name":"1 Departments of Emergency Medicine"},{"name":"Olive View\u2013UCLA Medical Center 2 Department of Medicine, Division of Infectious Diseases ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anusha","family":"Krishnadasan","sequence":"additional","affiliation":[{"name":"1 Departments of Emergency Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scot E.","family":"Dowd","sequence":"additional","affiliation":[{"name":"MR DNA 5 , Shallowater, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney M.","family":"Finegold","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles 3 Department of Medicine, Division of Infectious Diseases , , Los Angeles, California"},{"name":"Healthcare System, The David Geffen School of Medicine at UCLA 3 Department of Medicine, Division of Infectious Diseases , , Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula H.","family":"Summanen","sequence":"additional","affiliation":[{"name":"VA Greater Los Angeles 3 Department of Medicine, Division of Infectious Diseases , , Los Angeles, California"},{"name":"Healthcare System, The David Geffen School of Medicine at UCLA 3 Department of Medicine, Division of Infectious Diseases , , Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Talan","sequence":"additional","affiliation":[{"name":"1 Departments of Emergency Medicine"},{"name":"Olive View\u2013UCLA Medical Center 2 Department of Medicine, Division of Infectious Diseases ,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the EMERGEncy ID Net Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrick 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