Staph infection treatment

What is a staph infection

Staphylococcal infections – a variety of infectious diseases caused by bacteria – representatives of the group of Staphylococcus. Usually, symptoms of staph infection are presented in the following forms:

• abscesses (as of an abscess is indicated by limited, painful cavity resulting from inflammation and pus-filled),
• boils (furuncle is indicated by a small deposition under the skin, filled with pus, which is linked to the hair follicle),
• carbuncles (carbuncle is one of purulent skin diseases, pyoderma, can be relatively voluminous and is formed by combining several boils nearby),
• inflammation of the lungs (pneumonia),
• bacteremia (which means presence of bacteria in the blood),
• endocarditis (inflammation of the inner surface of the heart or endocardium, caused by microorganisms and mainly affects the cardiac valves),
• osteomyelitis (severe inflammation within the bone caused by bacteria),
• enterocolitis (inflammation of small intestine and colon, usually of infectious origin),
• gastroenteritis (a disease characterized by inflammation of the digestive system affecting the stomach and intestines).

Usually, a healthy organism is able to suppress bacterium, however, in the case of the presence of certain factors (chronic illness, malnutrition, vitamin deficiencies, immunosuppression, etc.) can develop a staph infection.

Causes/risk Factors

Bacteria belonging to the group of staphylococci can cause disease (i.e. are pathogenic staphylococci) are omnipresent. Typically, a significant portion of the healthy population are chronic bazillionaires (germ-carriers is called a condition in which the bacteria are from the places on the human body that has no sign of infection). In particular, Staphylococcus bacteria, usually in the body of a healthy person live in the nose (usually up to 30% of healthy people) and the skin (approximately 20% of healthy people).

People admitted to hospitals, and members of the medical staff of the hospital are carriers of the bacteria. Bacterial strains of staph that is resistant to antibiotics, occur, especially in hospitals. Some people are susceptible to staphylococcal infection much more than others.

This group includes:

• children's,

  

• nursing mother,
• patients suffering from the flu,
• people with chronic broncho-pulmonary diseases (i.e. diseases of the lower respiratory tract and lungs, such as cystic fibrosis or emphysema),
• individuals suffering from leukemia,
• cancer patient,
• people after transplantation,
• people after tracheotomy (a tracheotomy is called surgically created opening in the neck into the trachea to ensure breathing through a special tube),
• people with burns,
• patients with chronic skin diseases, surgical wounds,
• people suffering from diabetes,
• patients who entered an intravenous catheter (a plastic catheter that provides access to the vein of a person for drug administration),
• persons who for a long time used hormonal drugs from the group of corticosteroids and immunosuppressive drugs (i.e., drugs that inhibit the normal immune system),
• people after chemotherapy for cancer.

Predisposed individuals (i.e., more susceptible to infections, for reasons specified above) can acquire the infection in the first place, staphylococci colonizing their own body parts (i.e., bacteria normally inhabiting the body of a healthy person), but also to get infected from an asymptomatic carrier.

Unlike other staph infections, food poisoning occurs due to ingestion of food ready enterotoxin (enterotoxin is a toxin acting on the intestine and causing upset to some of its functions), which is produced in Staphylococcus-contaminated foods, and not the microorganism itself. In these cases the affected, in most cases, in otherwise healthy people.

Clinical picture

The main symptoms of staph infection due to the specific localization of the infection in the body of the affected person. For example, staphylococcal abscesses, toxic bullosa (disorder bullosa is characterized bypeeling of the surface layer of skin, the epidermis, accompanied by formation of large blisters) and scalded skin syndrome, which are typical for neonatal infection are observed, in most cases, during the first 6 weeks of life, manifested infection, localized skin lesions, the most common of which are abscesses (pustules, i.e. the cavity filled with pus) or bullae (education, created by combining several blisters together, causing a large cavity filled with pus).

These localized skin lesions (e.g., pustules or blisters) occur mainly in the axillary, inguinal or cervical folds. Much less frequently among children in this period, on the contrary, there is a induced by S. aureus subcutaneous abscess, exfoliation, bacteremia (penetration and the presence of bacteria in the blood), meningitis (inflammation of meninges) and inflammation of the lungs (pneumonia).

In lactating women who have in 1-4 weeks comes to the development of mastitis or abscess of the breast, must be considered in infected patients the presence of staphylococci that are resistant to conventional antibiotics. The source of this infection with resistant staphylococci, most often, are nurses caring for a child, and transmission occurs most likely through the child. In accordance with long-term observations it is believed that many newborns become infected staph in hospitals, in many cases because aseptic conditions (i.e., inappropriate hygienic environment).

Postoperative infection caused by bacteria from the group of staphylococci have various forms, namely from an abscess around the surgical sutures to extensive surgical infection. In some cases, infections develop within several days after the operation, in other cases only a few weeks after the operation. Such late manifestations, especially observed in people who during the surgical procedure were treated with drugs from the group of antibiotics.

Postoperative staphylococcal infection can also be complicated by development of toxic shock syndrome (toxic shock syndrome is characterized by high fever, vomiting, diarrhea, confusion, and rash, can quickly progress in some cases to the level of severe, irreversible shock, ending with the inevitable death of a person).

The development of staphylococcal pneumonia (pneumonia caused by Staphylococcus aureus) should be considered in all people suffering from influenza, which, in addition to the main symptoms develop shortness of breath, cyanosis (bluish coloration of the skin and mucous membranes with a high content of hemoglobin in the blood, which occurs when there is insufficient oxygenation of arterial blood in the lungs), followed by fever, which persists for a long time or appears several times in a row.

Lose staphylococcal pneumonia should also keep in mind those people who are hospitalized with chronic bronchopulmonary disease (long term disease of the bronchi and lungs) or other diseases with a high degree of risk, and who have developed fevers and tachypnea (rapid breathing), cough, cyanosis and leukocytosis (proliferation of white blood cells in the blood).

In newborns, the disease is staphylococcal pneumonia is characterized by rapid formation of abscesses and often empyema (purulent process in all body cavities, most often in the pleural cavity as a complication of pneumonia, the pleural cavity is the space between the two pleural layers).

Staphylococcal bacteremia may occur in connection with the abscesses, localized anywhere on the body, or in combination with established intravenous catheters and other foreign bodies, which are located in the human body.

In people with severe burns bacteremia is a very common cause of death.

Diagnostics

Diagnosis of staphylococcal infections is primarily based on the results of a thorough physical examination by a doctor, which usually show the above typical clinical symptoms of a staph infection. In order to confirm the validity of the diagnosis, however, in most cases, it is necessary to conduct laboratory tests and other additional tests.

In the case of the destruction of human staphylococcal abscesses microscopic examination of the pus shows the presence of polymorphonuclear leukocytes (polymorphonuclear leukocyte is neutrophil granulocytes, which represent 60-70% of circulating leukocytes, thus all white blood cells) and staphylococci (bacteria themselves) which can also be located inside of white blood cells.

Prevention

The most important item, as in the case of all other infectious diseases, is the prevention of staphylococcal infections. A substantial part of the preventive procedures to prevent the outbreak of a staph infection is the observance of hygienic rules (e.g., thorough washing of hands of medical personnel before and after examining each patient, sterilization of instruments used in the treatment of patients). In addition,all infectious patients should be isolated from susceptible persons. No man belonging to the attending medical personnel if he is suffering from a severe staphylococcal infectious diseases, even just the local symptoms, should not come in contact neither with patients nor with the instruments used for treatment.

Preventive measures

To reduce the risk of infection with Staphylococcus aureus, you should observe the following rules:

1. Carefully and frequently wash hands with soap and water,
2. In case of a cut or other wound, hold the wound clean until they heal, avoid contact with wounds of other people and contaminated material,
3. Don't lend your personal things to other people.

Treatment

Treatment of staph infection of any form involves, as a rule, based on abscess drainage (i.e., removal of accumulated pus) antibiotic therapy – in General the administration of drugs from group of antibiotics (critically ill patients, it is necessary in some cases antibiotics be administered parenterally i.e. intravenously or intramuscularly). Are necessary and supportive measures (e.g., support of vital functions, nutrition, supporting immunity, etc.).

The selections of samples of the affected tissue for microbiologic studies using cultivation (development of bacteria present in the sample by a special cultivation of the soil) should always be performed before antibiotic therapy, and prior to any change in the methods used in antimicrobial therapy.

In the hospital there is a majority of staphylococci are usually resistant to some antibiotics, such as Penicillin and Ampicillin. Thus, supplementation of these groups in staphylococcal infection treatment is not intended. They can be used only in cases when it was previously proven sensitivity to these antibiotics for a certain bacterial strain, isolated from a diseased sample.

Treatment of staph infection suggests using the following types of antibiotics (most strains of staph bacteria sensitive to them):

1. Penicillinase – resistant Penicillins (Methicillin, Oxacillin, Nafcillin, Cloxacillin, Dicloxacillin),
2. Cephalosporins (Cephalothin, Cephalexin, Cefamandol, and Cefoxitin or group of Cephalosporins of the 3rd generation),
3. And also: Gentamicin, Vancomycin, Lincomycin and Clindamycin.

The drug of first choice for treatment of people suffering from staph infection, is usually one of the above penicillin, although the efficacy of Vancomycin and Cephalosporin is the same. Many staphylococcal strains of bacteria also react to the introduction of these antibiotics, such as Erythromycin, Tetracyclines, Aminoglycosides, Bacitracin and Chloramphenicol. However, the antibiotics Chloramphenicol and bacitracin are entered only in rare cases because of their serious adverse side effects and existing competitive opportunities a safer treatment with antibiotics.

The selection of the appropriate specific antibiotic used for treatment, and determining the appropriate dose depends on the localization of infection in humans, the severity of the disease and, finally, determining the sensitivity of a microorganism to particular antibiotics.

In the treatment against some resistant bacterial strains of Staphylococcus aureus (Staphylococcus aureus, MRSA) can be an effective introduction of the antibiotic Imipenem/Cilastatin or any antibiotic from the Quinolone group. However, the drug of first choice in treatment of this bacterium is the antibiotic Vancomycin, which is administered by intravenous injection. Usually the dose for adults if they have normal kidney function is 500 mg Vancomycin intravenously every 6 hours or 1000 mg every 12 hours intravenously as an infusion (injected into a vein slowly over at least 1 hour). If a person has reduced kidney function, you need intravenous dose of the antibiotic Vancomycin to adjust (i.e., significantly reduce).

The total time of treatment by administration of antibiotics depends on the localization of staphylococcal infections in humans and clinical response. In most cases a person suffering from a certain form of staph infection, while the antibiotics lasts 2-4 weeks.

As alternative treatment of infections caused by resistant strains of bacteria Staphylococcus aureus (Staphylococcus aureus, MRSA) in adults can be used chemotherapeutic drugs, in particular, the drug Sulfamethoxazole/Trimethoprim, which is administered in doses of 50 mg Sulfamethoxazole/10 mg Trimethoprim, or 75 mg of Sulfamethoxazole/15 mg of Trimethoprim per kilogram of body weight, the daily intake divided into 2-3 doses (one dose every 8 or 12 hours), therapeutic course lasts for 2-4 weeks.

In addition, the antibiotic Rifampicin, and the Aminoglycosides can be a good addition to the treatment of these serious infections, especially in those cases when a staph infection associated with the presence of foreign bodies in the body or with lesions of the serous cavities.

For the successful treatment of an individual suffering from a staphylococcal enterocolitis, suitable use of antibiotics, which after administration, atpossible, is not absorbed at all or absorbed only in limited quantities from the gastrointestinal tract (such antibiotic, for example, is Vancomycin, but it needs to be administered orally and not intravenously, at a dose of 250-500 mg every 6 hours until regression of clinical symptoms).

In the treatment of asymptomatic carriers of resistant bacterial strains Staphylococcus aureus (carriers of Staphylococcus aureus, MRSA), we recommend taking these antibiotics, such as Cloxacillin, Dicloxacillin, Ciprofloxacin or Mupirocin, as well as chemotherapeutic agents (Sulfamethoxazole/Trimethoprim).