Staphylococcal infection. Staphylococcus aureus - Causes, symptoms and treatment. MF.

Staphylococcal infection is a common name for diseases caused by staphylococcus aureus. In connection with the high resistance to antibiotics, staphylococcal infections occupy the first place among purulent-inflammatory infectious diseases. Staphylococcus can cause inflammation in almost any organ. Staphylococcus can be the cause of purulent diseases of the skin and subcutaneous tissue: furuncles, panaricians, abscesses, hydradenitis, pyoderma. Affecting internal organs, staphylococcus can cause pneumonia, tonsillitis, endocarditis, osteomyelitis, meningitis, abscesses of internal organs. Isolated by staphylococcus enterotoxin, can cause severe food intoxication with the development of enterocolitis( inflammation of the small and large intestine).

The genus of staphylococci includes three types: Staphylococcus aureus( the most harmful), epidermal staphylococcus( also pathogenic, but much less dangerous than golden staphylococcus) and saprophytic staphylococcus is practically harmless, yet also capable of causing disease. In addition, each of the types of staphylococcus has several subspecies( strains), differing from each other in different properties( for example, a set of produced toxins) and, respectively, causing the same diseases, differing clinic( manifestations).Under the microscope, staphylococci appear as clusters of something similar to a bunch of grapes.

Staphylococci are distinguished by a fairly high viability: up to 6 months they can persist in the dried state, do not die during freezing and thawing, they are resistant to direct sunlight.

The pathogenic effect of staphylococci is associated with their ability to produce toxins: exfoliatin, damaging skin cells, leukocidin, destroying leukocytes, enterotoxin, which causes a food poisoning clinic. In addition, staphylococcus produces enzymes that protect it from the effects of immune mechanisms and contribute to its preservation and spread in the tissues of the body.

The source of infection may be a sick person or an asymptomatic carrier, according to some sources up to 40% of healthy people are carriers of various strains of Staphylococcus aureus. The entrance gates of infection can be microdamages of the skin, the mucosa of the respiratory tract. A significant factor in the development of staphylococcal infections is the weakening of immunity against the background of the use of medications( eg, immunosuppressants, antibiotics), chronic diseases( diabetes mellitus, thyroid disease), the effects of unfavorable environmental factors. Because of the peculiarities of the immune system, the most severe infections are those of young children and old people. Immunity after the transferred infection is unstable and, in general, insignificant, since when meeting a new subspecies of staphylococcus, which produces other toxins, all the previous immune "acquisitions" do not have a significant protective role.

Symptoms of staphylococcal infection

Specific manifestations of staphylococcal infection are determined by the site of introduction, the degree of aggressiveness of the type of staphylococcus and the degree of decrease in immunity.

Pyoderma is one of the most common purulent skin diseases. Staphylococcal pyoderma is characterized by a lesion of the skin in the region of the mouth of the hair. With superficial lesions develops the so-called folliculitis - a small abscess, in the center permeated with hair. With deeper lesions develops furuncle - purulent-necrotic inflammation of the hair sac and surrounding tissues or carbuncle - inflammation of the skin and subcutaneous tissue around the group of hair sacs. Most often, boils and carbuncles appear on the back of the neck, thighs, buttocks. Especially dangerous is the appearance of boils and carbuncles on the face - due to the peculiarities of blood circulation, staphylococcus can be introduced into the brain, with the development of purulent meningitis or brain abscess.

Symptoms of pyoderma with staphylococcal infection

Ritter disease or scalded skin syndrome is another manifestation of staphylococcal infection, found mainly in newborns and young children. The manifestations of the disease may resemble scarlet fever( a similar rash) or erysipelatous inflammation( the focus of red inflamed skin with flat boundaries), occurring in streptococcal infections. One of the forms of the disease - epidemic pappear, is a clear example of the action of staphylococcal toxin - exfoliatin. Surface layers of the skin with pemphigus exfoliate in large layers, beneath them large bubbles appear.

Abscesses and phlegmon are a form of deep lesion of subcutaneous tissues with their purulent fusion. The difference between abscess and phlegmon is that in the first case the inflammation is delimited by a capsule blocking the way to further spread of the process, and with phlegmon the purulent inflammation spreads through the tissues( that is, it is a more dangerous form).

Staphylococcal pneumonia is a rare phenomenon, but due to the peculiarities of the course and the stability of staphylococci to a number of antibiotics, it acquires great importance among bacterial pneumonia.
Pneumonia caused by staphylococcus is characterized by severe course, with severe intoxication, chest pain( pleural injury), dyspnea. Multiple foci appear in the lung tissues, followed by purulent fusion, the formation of abscesses. Such abscesses can break into the pleural cavity: a so-called empyema is formed.

When entering the foci of infection on the face, in the sinuses of the nose or other places with blood flow to the brain, staphylococcus causes the appearance of brain abscesses and purulent meningitis. Brain abscesses are usually small, scattered throughout the tissue. Meningitis is often secondary to an abscess of the brain, or can occur independently when a large number of staphylococci in the blood( bacteremia).The defeat of the brain and its membranes is manifested by headache, a violation of consciousness, neurological disorders, epileptic seizures.

Staphylococcal infection can also cause thrombophlebitis of superficial veins of the brain, accompanied by severe neurologic disorders.

Staphylococcus is the main cause( up to 95%) of a purulent inflammation of the bone marrow - osteomyelitis. In the process of inflammation all layers of bone are affected and destroyed, often a purulent focus breaks out. The main sign of osteomyelitis is pain in the area of ​​lesion. Later, there is swelling of the tissues over the site of inflammation, purulent fistula is formed. With lesions of joints, purulent arthritis occurs, with hip and knee joints most often affected.

Staphylococcal disease of the valves and inner shell of the heart( endocardium) endocarditis is a serious disease with a high( 40-60%) mortality. Getting with blood flow, staphylococcus in a short time destroys the heart valve, causing serious complications in the form of embolism( blockage) of peripheral arteries, myocardial abscess, heart failure.

Diseases caused by exposure to a large number of staphylococcal toxins are sometimes isolated into a separate group - intoxications. These include toxic shock and food toxicosis. Toxic shock occurs when particularly aggressive types of toxins enter the blood, causing a sharp drop in blood pressure, fever, abdominal pain, nausea, vomiting, diarrhea, headache, impaired consciousness, and later a characteristic spotted rash appears. Foodborne toxemia occurs 2-6 hours after ingestion of food contaminated with staphylococcus, and is manifested by nausea, vomiting, diarrhea, and abdominal pain. In severe cases of food intoxication manifestations of enterocolitis may resemble those with an especially dangerous infection - cholera.

Sepsis is the most severe form of staphylococcal infection, in which a large number of bacteria carry blood through the body with the formation of multiple secondary foci of infection in the internal organs.

Diagnosis of staphylococcal infection

The diagnosis of staphylococcal infection is based on clinical signs of the disease. To identify the pathogen make crops shed from the wounds, biological fluids. The basis for the diagnosis of food intoxication is the isolation of staphylococcus from food products. In establishing the diagnosis, the doctor must differentiate staphylococcal diseases with infections caused by streptococcus, allergic skin lesions, skin form of anthrax( carbuncle), intestinal infections( salmonellosis, dysentery).

Treatment of staphylococcal infections

Treatment of staphylococcal infections should be aimed at suppressing the pathogen, restoring immunity components, treating associated diseases that reduce the reactivity of the body.

The surgical method of treating foci of staphylococcal infection with purulent melting( furuncles, abscesses) has been considered the main one since antiquity and remains so until now.

The use of antibiotics for staphylococcal infections should be well thought out and justified, since the irrational use of antibiotics is at least not beneficial and, given the high resistance of staphylococci to certain antibiotics, in some cases is harmful, leading to an increase in the course of infections. For the treatment of staphylococcal processes, semi-synthetic penicillins( ampicillin, oxacillin), penicillins combined with clavulanic acid( amoksiklav) or another group of antibiotics - aminoglycosides( gentamicin) are more often used.

Bacteriophages with staphylococcal infection

Bacteriophages can be used to control staphylococcus - viruses with a selective ability to kill staphylococcus. For external treatment, ointments containing antibacterial components with antiseptic and restoring action are used. In purulent processes, it is not recommended to use ointments that have a fatty base( for example, the popular Vishnevsky liniment), since fats prevent the outflow from being separated from the wound, thereby worsening the course of the process.

Increased immunity for staphylococcal infection

Methods of enhancing immunity can be selected from a variety of adaptive preparations( ginseng, eleutherococcus) to complex combinations that include synthetic immunomodulators, the introduction of ready-made immune medications: antistaphylococcal plasma or immunoglobulin. Often an uncomplicated method of immunostimulation called autogemotherapy is used( intramuscular injection of the patient's own blood).

To improve recovery processes, multivitamins are prescribed with a tonic purpose. In diseases accompanied by high intoxication, fever, it is advisable to drink abundantly.
The diet as for any patient should be easily digestible with enough vitamins. A variety of healthy nutrition plays a significant role in maintaining the defenses of the body and rapid recovery after disease.

Folk remedies for the treatment of staphylococcal infection

Folk remedies can be used as the only independent method for non-severe forms of staphylococcal infection. These methods are based on the use of infusions and decoctions of herbs that have antibacterial and anti-inflammatory properties( chamomile, string, St. John's wort, calendula) both in the form of rinses and lotions, and for oral administration. Infusions of berries rich in vitamins( raspberries, cranberries, currants, rosehips) contribute to the elimination of bacterial toxins and the restoration of the body. Thermal procedures are recommended to be used topically and only during the recovery period. Heat to accelerate the ripening of abscesses, sauna, sauna and even more hot baths is not practical due to the danger of weighting and further spread of infection .

Prevention of staphylococcal infection

Prevention of staphylococcal infection includes: compliance with personal hygiene, avoiding bad habits, healthy eating and full sleep. It is necessary to avoid general hypothermia and overheating, in time to treat antiseptics( iodine, zelenka) microtrauma skin. It is necessary to identify and treat carriers of Staphylococcus aureus, especially those working in health care and public catering establishments, for the duration of treatment such persons are not allowed to perform their duties.

Doctor's consultation on staphylococcal infection:

Is there a vaccine for streptococcal infection?
Answer: there is a so-called staphylococcal anatoxin, after administration of anti-toxic antibodies, vaccines stimulating the production of antibacterial immunity are not present.

I often have furuncles( carbuncles, pimples, etc.).What it is necessary to have a drink that has passed or has taken place?
Answer: when manifesting a chronic staphylococcal infection, one should not self-medicate. It is necessary to consult a doctor - the treatment of infection should be prescribed individually after a detailed examination, you need to undergo medical treatment under the supervision of a doctor.

I have dysbiosis, have been diagnosed with the carriage of Staphylococcus aureus, an antibiotic has been prescribed. How long does it take to take it?
Answer: Treatment of the carriage of Staphylococcus aureus with antibiotics is impractical. It is desirable to use a staphylococcal bacteriophage and immunization with staphylococcal anatoxin. Treatment with antibiotics of dysbacteriosis with a high content of staphylococcus is completely contraindicated, as this will lead to the opposite result - more intensive reproduction of staphylococcus

Therapist doctor Sokov SV