How to treat staphylococcus in adults. Is it possible to cure Staphylococcus aureus with folk remedies? Treatment of Staphylococcus aureus in adults

Staphylococcus aureus(Staphylococcus aureus) is a spherical, non-motile and aerobic (able to live in air) Gram-positive bacterium that causes various diseases in children and less commonly in adults.

Staphylococcus aureus received its name from the golden glow that it emits when sown on a nutrient medium. Translated from the Greek slaphyle - "bunch" and coccus - "spherical", staphylococcus under a microscope resembles a bunch of grapes. Staphylococcus aureus is widely distributed in environment, it can be sown from household items, from toys, from medical instruments, from breast milk and affected skin and mucous membranes of a sick and healthy person.

What is dangerous Staphylococcus aureus

Normally, Staphylococcus aureus lives on the skin and mucous membranes in almost all people. But healthy people with good immunity do not get staph infection, because normal microflora inhibits the growth of staphylococcus and does not allow its pathogenic essence to manifest. But when the body's defenses are weakened, the microbe "raises its head" and causes various diseases, up to blood poisoning or sepsis.

The high pathogenicity of Staphylococcus aureus is associated with three factors.

• Firstly, the microorganism is highly resistant to antiseptics and environmental factors (withstands boiling for 10 minutes, drying, freezing, ethyl alcohol, hydrogen peroxide, with the exception of "brilliant green").
• Secondly, Staphylococcus aureus produces the enzymes penicillinase and lidase, which makes it protected from almost all antibiotics. penicillin series and helps to melt the skin, including the sweat glands, and penetrate deep into the body.
• And thirdly, the microbe produces endotoxin, which leads to both food poisoning and the syndrome of general intoxication of the body, up to the development of infectious toxic shock.

And, of course, it should be noted that there is no immunity to Staphylococcus aureus, and a person who has had a staphylococcal infection can become infected with it again.

Staphylococcus aureus is especially dangerous for infants in the hospital. It is in hospitals that the concentration of this microbe in the environment is high, which attaches great importance to the violation of the rules of asepsis and sterilization of instruments and the carriage of staphylococcus among honey. personnel.

The reasons

It is indisputable that the cause of a staphylococcal infection is, as a rule, Staphylococcus aureus. Infection occurs with a decrease in immunity, which is facilitated by a number of factors:

• taking antibiotics and hormonal drugs;
• stress;
• malnutrition;
• hypo- and beriberi;
• infections;
• intestinal dysbacteriosis;
• non-compliance with the rules of personal hygiene;
• immaturity of the child at birth;
• artificial feeding;
• late attachment to the breast.

Types of staph infection

There are generalized and local forms of staphylococcal infection.

Generalized forms include sepsis (septicopyemia and septicocemia).

Local forms include diseases of the skin, mucous membranes, internal organs, bones, joints, mammary glands and umbilical cord. Also, a separate column should highlight food poisoning with staphylococcus endotoxin.

In addition, staphylococcal infection can be primary and secondary (in the presence of a primary focus). Along the course, acute, protracted and chronic forms are distinguished, and according to the severity of a staphylococcal infection, mild, moderate and severe.

Symptoms depending on the affected organ

Symptoms of a staphylococcal infection depend on the location of staphylococcus in the child's body and on the degree of decrease in the body's defenses. The main signs of a staphylococcal infection are

• increase in body temperature
• pronounced intoxication syndrome (lethargy, weakness, lack of appetite, nausea).

Omphalitis

Damage to the umbilical wound by a microbe, which is accompanied by swelling of the umbilical ring, purulent discharge from the wound. When the umbilical vein is involved in the process, a compacted and thickened vein is probed. There is also hyperemia, which spreads upward, towards the sternum.

Defeat skin

• With pseudofurunculosis (damage to sweat, not sebaceous glands), dense, red nodules appear in skin folds(accumulation of sweat glands), which then suppurate.
• Vesiculopustulosis is characterized by the formation of vesicles with liquid contents, which spontaneously open and a crust forms in their place.
• Exfoliative dermatitis (Ritter's disease), or "scalded skin syndrome", is characterized by the formation of large blisters that look like burns, then the skin sloughs off and unprotected wounds form.
• An abscess is a lesion of the deep layers of the skin with visible redness and induration. A cavity containing pus is formed.
• Panaritium - defeat of the extreme phalanx of the finger.
• Phlegmon - in the process, in addition to the skin, subcutaneous tissue is involved, which suppurates.

Eye damage

With damage to the mucous membrane of the eyes, conjunctivitis develops (photophobia, lacrimation, swelling of the eyelids, purulent discharge from the eyes).

Defeat respiratory tract

food poisoning

It develops when eating contaminated or spoiled food and proceeds with symptoms of acute enterocolitis. Characterized by fever, nausea, vomiting up to 10 or more times a day, loose stools mixed with greens.

Sepsis

Blood poisoning or sepsis occurs with severe immunodeficiency. The course of the disease is severe, with a very high temperature, severe symptoms of intoxication, impaired consciousness (from agitation to lethargy).

With the development of infectious-toxic shock, blood pressure drops sharply, the patient loses consciousness and may fall into a coma.

Septicopyemia - the circulation of Staphylococcus aureus in the blood with the formation of purulent foci, both on the skin of the child and in the internal organs.

With septicemia, the development of infectious toxicosis is characteristic. Septicemia can be complicated by the addition of pneumonia, the development of DIC, and so on.

Diagnostics

Differential diagnosis of staphylococcal infection should be carried out with streptococcal infection. In the diagnosis of diseases of staphylococcal etiology, the following are used: serological methods, characterized by speed and high accuracy:

• Standard in vitro coagulase test, which lasts 4 hours, but if the result is negative, it is extended by a day.
• Latex agglutination, which uses commercial kits of latex particles bound to staphylococcus antibodies (protein A, clumping factor, and a number of surface antigens), making it also useful for species and strain identification of the pathogen

Also use:

• General blood and urine tests (leukocytosis, neutrophilia, elevated ESR are detected in the blood, and protein, leukocytes, and staphylococci are found in the urine).
• Sowing biological material on nutrient media.

Sowing on nutrient media is carried out in order to identify the causative agent of the disease and determine its sensitivity and resistance to antibiotics.

Fecal culture should be done no later than 3 hours after defecation, swabs from the mucous membranes of the mouth and nasopharynx should be taken on an empty stomach, before brushing your teeth and before taking medication.

A smear for staphylococcal conjunctivitis is taken from the lower eyelid with a sterile swab dipped in distilled water and before washing.

At skin diseases smears are taken after preliminary treatment of the skin around the wound with an antiseptic solution and removal of necrotic areas (crusts) from the wound.

• Vidal agglutination reaction

Allows you to determine the dynamics of the disease and the effectiveness of treatment. It is carried out 2 or more times with breaks of 7-10 days. An increase in antibody titer in the blood of more than 1:100 indicates the progression of the infection.

• Phage typing of isolated staphylococci

Allows you to determine the sensitivity of the microbe to phage viruses to prescribe the appropriate treatment.

Treatment

In mild forms of staphylococcal infection, antibiotics are not required.

For moderate and severe forms semi-synthetic penicillins (amoxiclav) are prescribed, which are effective in the resistance of the microorganism to penicillins and cephalosporins (kefzol, ceftriaxone).

The duration of treatment depends on the severity of the disease and infection of the skin or internal organs (from 7 days to several months).

In case of purulent-inflammatory skin diseases (furunculosis, carbuncle, impetigo), local treatment is prescribed - mupirocin or pleuromutilin derivatives. In their absence, wounds can be treated with antiseptic solutions: brilliant green, hydrogen peroxide, potassium permanganate and antibacterial ointments (synthomycin, oleandomycin ointment, baktroban).

At conjunctivitis eyes are washed daily with a weak solution of potassium permanganate, and a 30% solution of albucid is instilled 4-5 times a day.

With purulent skin lesions ( abscesses, phlegmon) is a surgical opening of abscesses for the outflow of pus.

In addition, the appointment of an antistaphylococcal bacteriophage, antistaphylococcal plasma and immunoglobulin (for sepsis and severe diseases) is shown.

With staphylococcal food poisoning, antibiotics are not prescribed, anti-staphylococcal toxoid is used. Carry out gastric lavage and replenishment of circulating blood volume by intravenous infusions saline solutions(physical solution, glucose solution, rehydron and others).

For the prevention of intestinal dysbacteriosis, the use of antifungal drugs (diflucan, nystatin) in parallel with antibiotics is recommended.

At the same time, immunocorrective therapy is prescribed (vitamins of group B, C, levamisole, Taktivin and others).

The treatment of staphylococcal infections in children is carried out by a pediatric infectious disease specialist.

Methods of treatment are selected depending on the damage of certain organs. The child is hospitalized in a separate ward-box, where a daily change of bed and underwear and a daily shower of the patient are performed.

Complications and prognosis

Staphylococcus aureus is especially dangerous for children. infancy. Possible complications:

• sepsis;
• infectious-toxic shock;
• coma;
• fatal outcome.

The prognosis depends on the severity of the disease and the effectiveness of treatment.

With mild lesions of the skin and mucous membranes, the prognosis is favorable. Massive infection with Staphylococcus aureus, especially with the development of sepsis in 50%, ends in death.

- a type of spherical gram-positive bacteria from the genus Staphylococcus aureus. According to the data medical statistics up to 40% of the human population are carriers of this pathogen. A favorite location is the nasopharynx, respiratory tract, and skin.

History reference

Staphylococcus aureus - bakposev

The bacterium was isolated in purulent masses from a postoperative wound in the 19th century. A distinctive feature of this representative of the opportunistic flora is its bright color due to the presence of carotenoid pigments.

The bacterium is characterized by increased endurance. It is not afraid of direct sunlight, survives contact with 100% ethanol and hydrogen peroxide, and is resistant to many types of antibiotics and antibacterial substances.

Important! It is not staphylococcus itself that is dangerous, but the diseases that it causes. With a decrease in immune defense, the pathogen begins to colonize the mucous membranes. A simple contact with the skin during normal operation of protective cells is not dangerous to health.

Routes of pathogen infection

Staphylococcus aureus is a representative of the opportunistic pathogen and lives on the skin, mucous membranes. In addition, infection can occur exogenously.

Ways of transmission of staphylococcus:

• airborne;
• household - use of common objects;
• air-dust - a microorganism is able to exist in a dust cloud. Inhalation of polluted air causes infection;
• fecal-oral - non-compliance with the rules of hygiene, the disease of "dirty hands";
• contact during medical manipulations - when using poorly processed medical instruments. In addition, the equipment can be colonized by strains resistant to antibacterial agents.

The degree of damage to the body

Staphylococcus aureus - scrofula in an infant

In medical practice, 4 degrees of damage by a pathogenic microorganism are distinguished. Based on the data of bacterial culture of blood, urine or sputum, the doctor determines the tactics of managing the patient.

Degrees of defeat by Staphylococcus aureus:

• At the first stage, the pathogen is found in the nasopharynx, on the skin, in the reproductive organs. There is no inflammatory process. In this case, aggressive therapy is not required; debridement of the colonized area is sufficient.
• At the second degree, an examination of other organs and systems is recommended. Especially if the patient makes any complaints. Topical treatment and therapy with broad-spectrum drugs is recommended.
• In the third degree, the risk of developing an inflammatory process increases. The doctor will insist on antibacterial and immunostimulating therapy.
• The fourth degree requires an antibiogram. Preparations are selected according to the results of the analysis. Additionally, immunomodulators, vitamin complexes are prescribed.

The division into stages is rather conditional. Since under the influence of provoking factors, the number of microorganisms colonizing the body increases.

Medical tactics

Fence by a doctor of material for bakposev

When a pathogenic organism is damaged, it is not treated, but the disease caused by it. The general principle of therapy is the use of antibiotics and antibacterial agents.

At the initial stage, broad-spectrum drugs are prescribed. If treatment is ineffective, correction of prescriptions is indicated according to the results of bacterial culture and antibiogram.

What the doctor will prescribe:

1. Cephalosporin drugs - Cefazolin, Cefalexin, Cefix, Zacef, Cefatoxime. This group has a bacteriostatic effect, suppressing the division of pathogenic flora. Tablets and injectable forms of medicines are used.
2. Synthetic antibiotics of the penicillin series - Oxacillin, Methicillin - are active against staphylococci resistant to benzylpenicillin and phenoxymethylpenicillin. It is used for bacterial infection of the nasopharynx, meningitis, lesions of the skin and intestines.
3. Glycopeptide antibiotics - with the ineffectiveness of cephalosporin drugs. A typical representative is Vancomycin, Teicoplanin, Fusidin, Linezolid.

In addition to antibiotics, the doctor will prescribe drugs of the sulfonamide group - Biseptol, Bisept.

Antibacterial drugs

Depending on the disease caused by staphylococcal flora, the use of local antiseptics is indicated. These can be ointments, solutions for local treatment, douching in gynecological practice. With frequent relapses of staphylococcal infections, these drugs should be in the home medicine cabinet.

List of antibacterial agents that suppress pathogenic flora:

• Furatsilina solution;
• St. John's wort in the form of a decoction or tincture;
• Bactroban in the form of an ointment;
• Hexachlorophene ointment;
• Chlorophyllipt alcohol and oil infusion;
• Lysozyme;
• Rivanol;
• Boric acid;
• Lugol solution in glycerin;
• Iodine 3 and 5%;
• Candles based on povidone-iodine;
• Potassium permanganate in solution;
• methylene blue;
• Octenisept;
• Fukortsin.

During periods of decreased immune defense of the body with the proven presence of staphylococcal flora, it is recommended to use local antiseptics as a means of prevention.

bacteriophages

You can get staphylococcus aureus if you don't practice good hygiene.

Important! A certain type of bacteriophage acts only on a certain type of bacterial agent and does not affect other cells. To eliminate Staphylococcus aureus, staphylococcal and pyobacteriophage watered are produced.

The indication for prescribing drugs in this group is the treatment of diseases caused by staphylococcus aureus:

1. pathology of ENT organs, lungs, bronchi;
2. surgical infections - suppuration of wounds, phlegmon, abscesses, mastitis, paraproctitis;
3. urogenital diseases - nephritis, urethritis, colpitis;
4. gastrointestinal diseases - intestinal infections;
5. treatment of postoperative wounds;
6. prevention of hospital infections.

The drugs of this group are used in conjunction with taking antibacterial agents or as a monotherapy for antibiotic intolerance.

Bacteriophages are used as follows:

• locally - treatment of wounds, sanitation of the vagina;
• orally - with diseases of the gastrointestinal tract;
• rectally - administered with the help of - with damage to the intestines, perianal region.

The duration of treatment depends on the severity of the disease. The standard course is from 7 to 20 days. Contraindications to the use of bacteriophage:

1. individual intolerance;
2. children's age up to 7 years.

Cases of overdose are not described in the medical literature. About side effects bacteriophages are absent.

ethnoscience

An effective remedy for the treatment of staphylococcal infections is an oily and alcohol solution of Chlorophyllipt. The drug acts even on antibiotic-resistant strains. Chlorophyllipt is used for rinsing, irrigation of wounds, instillation.

The course of treatment is from 7 to 14 days. The use of the drug does not exclude therapy with other drugs.

Other recipes traditional medicine:

• Black currant - berries have a bactericidal effect on the pathogenic flora, increase the body's resistance to the pathogen. It should be taken 1 glass of blackcurrant 3 times a day. The course of treatment is from 2 to 6 weeks.
• Tincture.
• Propolis is crushed and poured with alcohol or vodka. Insist in a dark place for 2 weeks.
• Alcohol tincture has a powerful bactericidal effect. Use for external treatment of wounds.
• Apricot puree is rich in natural phytoncides that have anti-inflammatory and antibacterial effects. Fresh pulp is applied to purulent wounds, puree is taken orally 2 times a day.
• Sage and burdock - decoctions of these herbs have proven themselves in the treatment of staphylococcal infections. For 5 g of plant mass, 1 cup of boiling water is required. Pour. Let it brew. Bury in the nose or use as a gargle 3-4 times a day.

The use of traditional medicine recipes should be discussed with your doctor. They are allowed in complex therapy but not as the only treatment.

Immunostimulants

Staphylococcus aureus

This class of substances activates the body's own immune capabilities to suppress pathogenic flora.

Antistaphylococcal immunoglobulin is a preparation containing antibodies to the causative agent of the disease. The substance has no bactericidal or bacteriostatic effect.

The drug is administered intramuscularly. After the introduction, an increase in temperature is possible. Antistaphylococcal immunoglobulin is not a monotherapy.

Autohemotransfusion - transfusion of the patient's own blood. The biological fluid is administered intramuscularly. After the injection, the destruction of the blood occurs. It causes immune response organism.

Herbal immunomodulators - tinctures and decoctions of ginseng root, echinacea, rotar thistle, pink radiola. It is recommended to take courses in the cold season, as part of complex therapy for relapse of the disease.

Is it possible to get rid of Staphylococcus aureus

Staphylococcus aureus, like other representatives of this group, are normal inhabitants of our body. But their number should not exceed, for example, in the pharynx 102 cfu / ml.

Exceeding normal values ​​indicates that the disease is caused by this particular pathogen. The basic principle of therapy:

• Reducing the amount of the pathogen to a safe level.
• Eliminate the clinical manifestations of the disease.
• Minimizing the risk of relapse.

It is impossible to get rid of Staphylococcus aureus. But it is quite possible to cure the disease caused by it.

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Staphylococcus aureus (Staphylococcus aureus) can cause the most various diseases- from harmless skin lesions in the form of acne to deadly dangerous infections including sepsis and toxic shock.

General information

Almost every person has to deal with infections caused by Staphylococcus aureus (SA) throughout life. This microorganism can affect any organs and systems of the body, and the spectrum of clinical manifestations of staphylococcal infection is extremely diverse - about 120 diseases. In addition, S. aureus is one of the most common causes of nosocomial infection, causing a variety of postoperative complications.

The issue of choosing a rational treatment for GL infection due to the emergence of multidrug-resistant strains is extremely relevant. For example, in clinical practice methicillin-resistant staphylococcus aureus (MRSA) has long been known to be resistant to beta-lactam antibiotics - penicillins, cephalosporins, carbapenems. AT last years even more resistant strains of GL have also appeared - vancomycin-resistant (VRSA) and glycopeptide-resistant (GISA).

Staphylococcus aureus can stay in the environment for a long time: up to 12 hours in direct sunlight, withstands temperatures of 150 ° C for up to 10 minutes, does not die even in pure ethyl alcohol and hydrogen peroxide. It is found in the human flora on the skin and mucous membranes (most often the nasal cavity) in healthy people. Usually this microorganism does not cause infection of healthy skin, however, if GL penetrates into the bloodstream and from there to other tissues of the body, it can cause more than 100 dangerous diseases. Activation of GL, which is part of the opportunistic microflora, is most often associated with a decrease in the body's immune defenses.

The main reservoir of the AP is the human body. Transmission of the pathogen usually occurs by direct contact or by airborne droplets (when talking, sneezing, coughing). However, some cases of infection are associated with other modes of transmission - through food and medical instruments.

Cell wall components

The cell wall of Staphylococcus aureus plays an important role in its ability to induce infectious disease in a specific person. It is also the most important factor determining the ability of GL to survive in adverse conditions, as well as to resist the action of antibiotics.

Staphylococci are Gram-positive bacteria, and their cell walls consist of peptidoglycan, teichoic acids, and protein A. It is these components of the bacterial cell that determine the great adaptive capabilities of GL.

Peptidoglycan is a kind of macromolecular sac that covers the entire cell. It consists of glycan strands that are cross-linked with peptide bridges, providing structural integrity and strength to the cell wall. It is the formation of these bridges that the action of beta-lactam antibiotics is aimed at, however, many GL strains have learned to resist their action, which has led to the emergence of a whole population of GL resistant to the action of many antibiotics.

Teichoic acids play a critical role in determining cell shape, regulating cell division, and other aspects of bacterial physiology. They also play a role in antibiotic resistance, protect Staphylococcus aureus from the damaging effects of antimicrobial fatty acids human skin.

Protein A binds to a specific site on antibodies produced by the body to fight staph. This subsequently leads to a violation of the absorption of bacterial cells by phagocytes, prevents their destruction.

Toxins and Enzymes

Among the toxins produced by Staphylococcus aureus, the following can be distinguished:

• exfoliative toxins(epidermolytic exotoxins) - are exotoxins involved in the occurrence of scalded skin syndrome (Ritter's disease), which is most common in infants and early age;
• enterotoxins- 8 staphylococcal toxins are currently known to cause foodborne infections, for example, enterotoxin type B contributes to gastroenteritis, which is characterized by nausea, vomiting, diarrhea and abdominal pain;
• TSST-1 toxin- provokes toxic shock syndrome, which is characterized by fever, skin peeling, erythematous rash, falling blood pressure and multiple organ failure.

Staphylococcus aureus is able to secrete other toxins that act on cell membranes: alpha, beta and delta toxin, as well as several two-component toxins. In addition to toxins, Staphylococcus aureus produces various enzymes, such as coagulase, which thickens the plasma and coats the bacterial cell to prevent phagocytosis. Hyaluronidase (also known as proliferation factor) breaks down hyaluronic acid and promotes the spread of bacteria in the body. S. aureus also produces lipase for lipid digestion, which facilitates the penetration of staphylococcus into tissues. Staphylokinases produced by the bacterium are used to dissolve fibrin and help in penetration into various organs and systems, and beta-lactamase is used to develop drug resistance.

Staphylococcal toxins are the most important factors of pathogenicity of GS, they most often determine the pathogenesis of certain types of staphylococcal infections, as well as the clinical manifestations of the disease. The entry of toxins into the blood leads to intoxication of the body, up to toxic shock.

Method of infection with staphylococcus aureus

Anyone can develop a staph infection, but there are some groups of people who are at greater risk.

Various factors, most notably the condition immune system may increase the risk of developing staph infections. These include:

• diabetes;
• HIV AIDS;
• renal failure requiring dialysis;
• weakening of the immune defense due to acute infections or chronic diseases;
• taking medications that suppress the immune system (immunosuppressants, glucocorticoids);
• malignant neoplasms;
• radiation or chemotherapy;
• skin lesions (eczema, insect bites, trauma, surgical wounds, burns);
• chronic lung diseases (cystic fibrosis, emphysema);
• the presence of invasive devices (urinary and vascular catheters, dialysis and breathing tubes, drains).

Staphylococci are most commonly transmitted by direct or indirect contact with a person who has a wound or clinical infection of the respiratory or urinary tract with a staphylococcal nature. Methicillin-resistant GL can be hand-carried medical worker, this is a common way of its transmission between patients and medical staff. Contaminated surfaces and medical equipment are also sources of staph infection.

There is also an airborne method of infection with Staphylococcus aureus. When an infected person coughs or sneezes, numerous small droplets of saliva are released into the air and remain suspended in the air. They contain bacteria and can infect others.

Another way of transmission of infection is fecal-oral, through food contaminated with staphylococcus aureus, water. This transmission route is due to the ability of GL long time be in the external environment where it survives due to the structure of the cell wall, which has a high osmotic stability.

Most often, Staphylococcus aureus is transmitted with foods such as meat, fish, eggs, and dairy products. In them, it is not only well preserved, but also able to even multiply under favorable conditions.

Types and symptoms of staph infection

Staphylococcal infections can range from small skin rashes such as acne and impetigo to pneumonia, meningitis, endocarditis, and life-threatening conditions such as sepsis and toxic shock. The table shows the main types of staphylococcal infections.

Types of staphylococcal infection:

Due to the variety of types of staph infections, their signs and symptoms also vary depending on the location and severity of the infection. Currently, about 120 forms of staphylococcal infection have been described, more than 100 of which are dangerous and sometimes life-threatening pathological conditions.

Rhinitis

Staphylococcus aureus is an opportunistic inhabitant of the flora of the nasal cavity. Nasal colonization with S. aureus does not immediately cause active infection or local symptoms. However, under certain conditions, it can provoke the occurrence of staphylococcal rhinitis. The state of the immune system plays a leading role in this. When it is weakened, most often AP infection occurs in the form of rhinitis.

Nasal infections caused by staph are usually secondary and develop after a cold, flu, surgery, inflammation, or injury to the nasal membranes. As a result of the addition of GL infection, the protective function of the epithelium deteriorates, and the respiratory function provided by the mucous membrane of the nasal passages - the filtration and heating of the inhaled air is disturbed.

The presence of yellow-green mucus in the nasal cavity and nasopharynx is a sign of an active response of the local immune system to a staphylococcal attack. Other symptoms are nasal congestion, soreness in the nose and throat, cough, fever. FROM further dissemination infections, the paranasal sinuses are involved in the pathological process, which leads to headache, even more fever, chills, sensations of pressure in the forehead, below the eyes. Headaches usually change in intensity with a change in body position and disappear soon after getting out of bed.

Staphylococcal rhinitis can also provoke an infection of the underlying parts of the respiratory tract in the form of tonsillitis, bronchitis, pneumonia. Due to seemingly banal rhinitis, staphylococcal lesions of distant skin areas may occur - boils, carbuncles, impetigo, cellulitis, abscesses. Bacteria can spread with the bloodstream to other organs and systems of the body, resulting in the development of formidable complications - scalded skin syndrome, pneumonia, otitis media, endocarditis, osteomyelitis, meningitis, toxic shock syndrome, sepsis.

Sinusitis

Sinusitis is an inflammation of the paranasal sinuses.

Depending on the localization, the following forms of sinusitis are distinguished:

• sinusitis- inflammation of the maxillary (maxillary sinus);
• frontitis- inflammation of the frontal sinus;
• ethmoiditis- inflammation of the mucous membrane of the ethmoid labyrinth;
• sphenoiditis- inflammation of the sphenoid sinus.

The most common symptom in patients with bacterial staphylococcal sinusitis is nasal congestion, pain in the maxillary region on the side of the affected maxillary sinus, a feeling of pressure and fullness, headache, toothache, increased body temperature, and purulent discharge from the nose.

Depending on the duration of the course, the following forms of sinusitis are distinguished:

• acute sinusitis– lasts up to 4 weeks and is the most common;
• subacute sinusitis- symptoms last longer than in the acute period - from 4 to 12 weeks;
• chronic sinusitis- Symptoms persist for 12 weeks or more or recur continuously.

While most sinus infections are uncomplicated, sometimes potentially life-threatening complications of acute bacterial sinusitis can occur, which include:

• infections of the eyes and surrounding tissues;
• education in paranasal sinuses blood clot(thrombosis);
• meningitis;
• brain abscess;
• bone infections (osteomyelitis).

Pharyngitis

About 10-15% of cases of sore throat are caused by staph infections.

The incubation period for bacterial pharyngitis is usually 2 to 5 days. Other symptoms that accompany pharyngitis vary, since pharyngitis is very often a manifestation of a secondary staphylococcal infection, which "layers" on another viral, bacterial or fungal infection.

Staphylococcus aureus can live in the throat as an opportunistic microorganism and not manifest itself until conditions favorable for its pathogenic activity (flu, SARS) appear that reduce immune protection.

The main symptoms of staphylococcal pharyngitis:

• sore throat;
• redness of the pharyngeal mucosa, the presence of purulent plaque;
• redness of the mucous membrane of the tonsils and the formation of purulent plugs on them;
• the appearance of small ulcers and erosions on the mucous membrane of the throat;
• hoarseness of voice;
• increase in body temperature;
• chills;
• headache;
• sore throat, which provokes a cough;
• enlargement of the cervical lymph nodes.

Laryngitis

Laryngitis is an inflammation of the larynx. The larynx is the part of the respiratory tract that connects the pharynx to the trachea and contains the vocal apparatus for producing sounds. Very often, with laryngitis, the inflammatory process also passes to the trachea, that is, we are talking about laryngotracheitis.

The most common causes of laryngitis are infections and trauma (chemical and mechanical damage, including vocal overexertion). Most cases of staphylococcal laryngitis are acute, meaning they last for a short period of time, from a few days (usually 7 to 10 days) to 2 to 3 weeks. Chronic laryngitis- inflammation of the larynx that lasts more than 3 weeks and can sometimes be associated with serious and even life-threatening diseases, including cancer.

The most common symptom of staphylococcal laryngitis is dysphonia - a qualitative change in the voice. He becomes hoarse, rough and hoarse. sometimes happens total loss voices - aphonia. Other symptoms may include sore throat, cough, and fever. Difficulty swallowing or discomfort and pain when swallowing may also be present. Pain when talking, especially when talking loudly, may also be present with laryngitis.

The mucous membrane of the larynx becomes inflamed, the infectious process can spread to the trachea, resulting in tracheitis. The patient feels dryness and sore throat, coughs, sputum, purulent discharge may appear.

Bronchitis

Bronchitis is an infection of the upper respiratory tract with a primary lesion of the bronchi, causing irritation and inflammation. The inflammatory process begins in the nasal cavity and nasopharynx, and then passes to the underlying sections of the respiratory tract, including the bronchi.

As a result of irritation by infectious agents and the resulting inflammatory process in the bronchi, the leading symptom of bronchitis occurs - cough - first dry, later wet (productive) with the release of a large amount of mucus.

Bronchitis is divided into acute and chronic. The course of bacterial staphylococcal bronchitis is often acute, lasting up to 3 weeks. main symptom acute bronchitis is a persistent cough with viscous sputum. In the case of staphylococcal bronchitis, the sputum has a yellowish-green tint. Other symptoms of acute bronchitis include wheezing, low-grade fever, sore throat, nasal congestion, discomfort and pain in the chest, in case of severe bronchitis, shortness of breath appears.

Pneumonia

Staphylococcal pneumonia is an inflammation of the lungs, characterized by a severe course, sometimes up to sepsis, frequent relapses and the formation of abscessing foci in the lung tissue. Staphylococcal pneumonia can be an independent disease or occur as a complication after other diseases (flu or acute respiratory infection).

Symptoms of the disease include:

• increase in body temperature;
• general malaise, chills, muscle weakness;
• cough, often with an admixture of pus or blood in the sputum;
• chest pain during coughing or deep breathing;
• severe shortness of breath, wheezing in the lungs;
• pallor, cyanosis of the skin;
• bloating, repeated vomiting;
• loose stool.

Staphylococcal pneumonia occurs in various forms:

• bullous form its other name is staphylococcal destruction, characterized by the formation of cavities (bulls) in the lungs already in the first days of the disease, the walls of these cavities are very thin, the prognosis for this form of the disease is usually favorable, however, after recovery, air cysts may form in the former foci of destruction (cavities);
• staphylococcal infiltrate- it is characterized by a severe course with severe intoxication, the patient's condition resembles sepsis, an X-ray examination reveals infiltrative blackout in a limited area, the disease resolves slowly - within 4-6 or more weeks, in the future, focal pneumosclerosis may form;
• abscess form- proceeds in two stages: before and after the breakthrough of the abscess into the drainage bronchus, the first period is characterized by a very severe course: fever with chills, severe intoxication, chest pain, shortness of breath, X-ray examination reveals the focus of infiltration of the lung tissue, after a breakthrough into the bronchus the patient coughs with the release of a large amount of purulent sputum, sometimes with blood impurities, after which the body temperature decreases, intoxication decreases, with auscultation of the lungs in the projection of the abscess, fine bubbling rales are heard, a pentgenological examination reveals a cavity with a horizontal level, sometimes several abscesses form, and then multiple cavities are determined;
• metastatic destruction- this form of staphylococcal pneumonia develops as a result of hematogenous migration of infection into the lungs from a purulent focus and is very difficult, as a rule, the lesion is bilateral, a septic condition develops, an X-ray examination of the lungs reveals multiple foci of abscess formation (cavities with a horizontal level of fluid in places of infiltration) in combination with bullae;
• pulmonary-pleural form- characterized by the development of infiltrative or abscessing foci in the affected lung in combination with the involvement of the pleura in the pathological process and the appearance of pyopneumothorax, pleural empyema.

With untimely access to a doctor or improper treatment of staphylococcal pneumonia, the following complications may occur:

• empyema and pleural effusion;
• catarrhal or purulent otitis media;
• abscess or sepsis of the lungs;
• acute endocarditis or spontaneous pneumothorax;
• metastatic lesions of internal organs or skin;
• toxic pathology of the myocardium (decrease in blood pressure, muffled heart tones);
• hemorrhagic syndrome (blood during coughing and skin rash).

Among young children, there is a high mortality rate in the complicated form of staphylococcal pneumonia.

Osteomyelitis

Osteomyelitis is a purulent-necrotic lesion of bones and bone marrow, nearby tissues are also often involved in the pathological process. A staphylococcal infection can enter the bones in several ways: from one part of the body through the bloodstream (hematogenous osteomyelitis), from inflammatory foci located near the bone, and as a result of open fractures or operations.

Staphylococcus aureus is the most common microorganism that causes this pathology in both adults and children, this bacterium is most often sown in the foci of infection. In children, the long tubular bones limbs, and in adults - the vertebral bodies and pelvic bones. Allocate acute and chronic form this pathology.

Acute osteomyelitis develops quickly - within 7-10 days. Most often, it occurs due to the transfer of GL with the blood flow from other foci of infection in the body to the damaged bone. Chronic osteomyelitis usually develops after injuries, in places of surgical wounds, due to impaired blood supply to the bone. Unlike other staphylococcal infections that have a rapid course, osteomyelitis caused by GL can be asymptomatic for several years, and then give out a spontaneous relapse with manifestations of an acute form of osteomyelitis.

Symptoms of acute and chronic osteomyelitis very similar and include:

• fever, irritability, fatigue;
• nausea;
• soreness, redness of the skin and an increase in its temperature in the affected area;
• swelling around the affected bone;
• violations of the range of motion in the adjacent joint.

Most cases of osteomyelitis can be cured. However chronic infections bones may require more long-term treatment and in some cases surgery. Treatment should be immediate and intensive.

Food poisoning

Staphylococcal food poisoning is a gastrointestinal illness caused by eating foods contaminated with toxins produced by the bacterium Staphylococcus aureus. People who carry GS can contaminate food with unwashed hands while preparing, packaging, and selling it. Often this applies to workers in the food industry, sellers, employees of canteens, cafes, restaurants.

The bacterium has a high osmotic stability, which allows it to be in environments with a high concentration of salt, sugar, protein. GL can not only be preserved in some products, but also multiply in them. Most often, such products are ham and poultry, unpasteurized dairy products, dishes with mayonnaise, eggs, potatoes, confectionery with cream. And although Staphylococcus aureus bacteria are easily killed by heat treatment, their toxins are resistant to heat and therefore cannot always be destroyed by cooking.

Staphylococcal toxins are fast-acting, and symptoms usually develop within 30 minutes to 6 hours. Patients usually experience nausea, vomiting, stomach cramps, and diarrhea. Fever for staphylococcal infection is not typical. The disease cannot be passed on to other people and is usually mild, with most people recovering within 1-3 days.

The most important thing in treatment is to consume plenty of fluids to reduce the intoxication of the body. Antiemetic drugs may be given to reduce vomiting and nausea. Patients with severe disease may require hospitalization, intravenous administration of saline solutions.

Prevention of staphylococcal food poisoning is to prevent bacteria from contaminating food.

The following precautions will help protect against staph poisoning:

• wash hands thoroughly with soap and water before handling, preparing and serving food;
• it is better to refuse cooking if there are manifestations of the disease - nausea, vomiting, diarrhea;
• if there are wounds or infections on the hands or wrists, gloves should be worn when preparing food;
• keep the kitchen, food preparation surfaces and food handling areas clean;
• store food at 4°C or below.

pyoderma

Pyoderma is a pustular skin lesion that occurs when it is damaged by the GL. The disease is extremely common in both adults and children. This is one of the most common skin diseases in childhood, more than 100 million children on the planet suffer from it.

A staphylococcal skin infection can manifest itself in a variety of ways:

• staphylococcal folliculitis- an infection in which the hair follicles become inflamed, it is characterized by the formation of clusters of small red or whitish pimples that develop around the hair follicles, blistering blisters are also formed, which later burst and crust over, the skin becomes tender and painful, itching and burning;
• furunculosis- also damage to the hair follicle, often has chronic course, this disease is one of the most common skin inflammatory pathologies that occurs as a result of acute purulent staphylococcal inflammation of the hair follicle and surrounding connective tissue, at the initial stage of the disease, a bright red inflammation forms around the hair follicle, dense to the touch, after a while the area of ​​inflammation begins increase in size, the tissue around it becomes painful and swollen, after three days from the onset of the disease, pus begins to form, and after another two days it breaks out, if the process is not accompanied by a secondary infection or complications, the wound begins to scar;
• carbunculosis- is an accumulation of clusters of boils, in which the infected mass is filled with fluid, pus and dead tissue, carbuncles can develop anywhere, but the most common place for their localization is the back and neck, men suffer from this disease more often than women;
• sycosis vulgaris- characterized by skin lesions in the growth zone of the beard and mustache due to deep damage to the hair follicles, tender erythematous papules and pustules can form around coarse hair near the beard or on the back of the neck;
• hydradenitis- purulent inflammation of the sweat glands, which is characterized by damage to such areas as the armpits, groin area and under the breasts, the first signs are the formation of small nodes on the skin that resemble acne, cysts, boils or folliculitis, as the disease progresses, they become larger and painful, then opened, released a large number of creamy pus, the infectious process ends with scarring of the affected skin.

Other staphylococcal skin infections include ecthyma vulgaris, cellulitis, and impetigo, although streptococcus is more likely to cause these infections. Skin infections of staphylococcal origin can also occur in the presence of wounds, dermatitis, scabies, diabetic ulcers.

Omphalitis

Omphalitis is an infectious inflammation of the skin of the umbilical ring and the umbilical region, which is characteristic mainly for newborns. Usually, the remnants of the umbilical cord are separated from the skin within 3-5 days after birth. A small amount of purulent material is usually observed at its base, so the umbilical wound is kept open to allow it to dry out.

Staphylococcus aureus can infect an unhealed umbilical wound, resulting in significant redness and swelling of the skin and subcutaneous tissue around the navel, a vascular pattern and red stripes appear, indicating the addition of lymphangitis. In some cases, the infection can spread through the hematogenous and lymphogenous routes to the rest of the body.

There are the following forms of omphalitis:

• catarrhal ("weeping navel");
• phlegmonous;
• gangrenous (necrotic).

Clinically, newborns with omphalitis have signs and symptoms of a skin infection around the remnants of the umbilical cord with involvement of nearby tissues. Omphalitis is characterized by redness, a local increase in skin temperature, swelling and pain, pus is released from the umbilical cord, fever, tachycardia, low blood pressure(hypotension). A newborn baby is drowsy, naughty, malnourished.

Treatment of omphalitis usually consists in treating the wound with antiseptic agents. However, in some cases, omphalitis can quickly progress to sepsis and is a potentially life-threatening infection, therefore, it requires immediate antibiotic therapy, and, if necessary, surgical treatment.

Endocarditis

Staphylococcal endocarditis is an infection that affects the inner lining of the heart (endocardium), as well as the chambers and valves of the heart. Staphylococcus aureus is one of the most common microorganisms responsible for infective endocarditis.

The infection is often acquired in medical institutions where staphylococcus can enter the bloodstream during various procedures that cause damage to the integrity of the skin, such as surgery, catheterization, or prolonged or constant use of a catheter.

The symptoms of endocarditis are not always severe from the start and may develop slowly. In the early stages of endocarditis, they are similar to many other diseases, not only of the heart, but also of other organs and systems - the respiratory, gastrointestinal tract, so many cases are difficult to diagnose in the early stages of the disease.

Common symptoms of endocarditis include:

• heart murmur;
• pale skin;
• fever or chills;
• night sweats;
• muscle or joint pain;
• nausea or decreased appetite;
• a feeling of fullness, swelling in the upper abdomen on the left;
• weight loss;
• swelling of the legs, abdomen;
• cough and shortness of breath.

Less common symptoms of endocarditis include:

• blood in the urine;
• weight loss;
• splenomegaly.

Skin changes may also occur, including:

• reddish or purple spots under the skin of the fingers or toes (Osler's nodes);
• tiny red or purple spots that usually appear on the skin, whites of the eyes, oral cavity(petechiae);
• red spots on the soles of the feet and palms of the hands (Janeway's symptom).

Signs and symptoms of infective endocarditis vary markedly in different patients. They can also change over time and depend on age, severity of the course of the disease, condition of cardio-vascular system and duration of infection. Staphylococcal endocarditis has a high mortality rate (40-60%), therefore, at the slightest suspicion of this disease, urgent hospitalization and immediate initiation of antibiotic therapy are necessary. If the valvular apparatus of the heart is damaged (occurs in 50% of patients) and the development of heart failure, valve replacement may be required.

Meningitis

Meningitis caused by Staphylococcus aureus accounts for 1-9% of all cases of bacterial meningitis. Staphylococcal meningitis is characterized by damage to the membranes covering the brain and spinal cord, which occurs against the background of bacteremia, as well as infection of the meninges during a brain abscess.

Risk factors for developing staphylococcal meningitis include:

• infection of the heart valves;
• head infection and spinal cord in history;
• recent neurosurgical operations (for example, the installation of shunts);
• brain and spinal cord injuries.

Symptoms can come on quickly and include:

• fever and chills;
• changes in mental status;
• nausea and vomiting;
• increased sensitivity to light (photophobia);
• severe headache;
• stiffness of the neck muscles.

Early treatment with rationally selected antibiotic therapy improves the outcome of the disease. However, some people do not survive as a result of staphylococcal meningitis. Young children and adults over 50 years of age have the greatest risk of death.

Damage to the organs of the genitourinary system

Among adults aged 20 to 50 years, genitourinary infections are 40-50 times more common in women, due to the anatomical and physiological characteristics of the female genitourinary system (practically unprotected entrance to the vagina, short and wide urethra, nearby potential source of infection - the anus) . In women of this age group, most infections are represented by cystitis or pyelonephritis, colpitis,. In men of the same age, urethritis or prostatitis is more common. Affecting the reproductive system, Staphylococcus aureus can also cause adnexitis, salpingitis, endometritis, vaginitis, balanitis in women, as well as balanoposthitis, vesiculitis, epididymitis in men.

Infection occurs in several ways:

• sexual intercourse without using a condom;
• ascending infection (germs enter the urethra or vagina and rise higher - to the kidneys or ovaries);
• with blood flow and lymph flow from other foci of infection.

For urinary infections characterized by the presence of a number of common, most common symptoms:

• discomfort and pain in the organs of the genitourinary system;
• itching in the vulva;
• tingling sensations;
• discharge from the vagina in women, from the urethra - in men and women;
• urination disorders of a different nature (burning and itching during urination, its difficulty, increased urge);
• on the external genitalia appear pathological discharge, raids, rash.

In addition, for each disease of the genitourinary system with the defeat of the GL, there are specific symptoms. For example, a kidney infection is characterized by lower back pain, epididymitis is characterized by reddening of the skin of the scrotum, an increase in its temperature, a tumor-like formation is palpable in it, and sexual function is impaired.

Bacterial infections of the genitourinary system can cause many complications, this is especially true for AP, so it is very important to diagnose the pathology in time and prescribe rational antibiotic therapy aimed at destroying the pathogen.

Damage to the visual apparatus

Usually staphylococci provoke the development of conjunctivitis - inflammation of the conjunctiva. The disease is contagious, but, as a rule, does not lead to serious consequences and is easily treated. More often one eye is affected.

Symptoms of the disease in a child and in an adult are the same:

• redness of the white of the eye (sclera), mucous membrane of the eyelids;
• swelling of the conjunctiva;
• lacrimation;
• yellowish purulent discharge, crusts over the eyelashes, especially after sleep, which makes the eyelids sticky;
• itching and burning in the eye;
• blurred vision;
• eyes are more sensitive to light.

Staphylococcal conjunctivitis is treated with antibiotics. eye drops, ointments or oral agents. As a result of treatment, the symptoms of the disease are eliminated within a few days, and the disease does not lead to complications.

Sepsis

Staphylococcal sepsis (colloquially, blood poisoning) is a potentially life-threatening condition associated with the presence of not only bacterial toxins in the blood, but also the microorganism itself. Sepsis develops when biologically active substances, which the immune system releases to fight staphylococcal infection, cause inflammatory reactions in all organs and systems of the body. Most often, its cause is foci of staphylococcal infection in the body or the presence of a wound surface affected by GL.

Severe cases of sepsis can lead to septic shock, which is a medical emergency. Doctors view sepsis as a three-stage syndrome that begins with normal sepsis and progresses through severe sepsis to septic shock. The goal of therapy is to treat sepsis for early stage before it gets more dangerous.

To confirm sepsis, a patient must have at least two of the following plus a probable or confirmed infection:

• body temperature above 38.3 °C or below 36 °C;
• heart rate above 90 beats per minute;
• respiratory rate above 20 breaths per minute.

Severe sepsis can be discussed when there is dysfunction of at least one organ. The patient must have one or more of the following:

• decrease in diuresis;
• a sharp change in mental status (septic psychosis);
• decrease in the number of platelets in the blood;
• labored breathing;
• abnormal heart function;
• stomach ache.

Symptoms of septic shock include symptoms of severe sepsis as well as very low blood pressure.

Most people recover from mild sepsis, but the mortality rate from septic shock is nearly 50%. In addition, an episode of severe sepsis increases the risk of future infections. Severe sepsis or septic shock can also cause complications. Small blood clots can form throughout the body. The resulting blood clots block blood flow and oxygen delivery to vital organs, which increases the risk of organ tissue necrosis and failure (gangrene).

Diagnostics

Diagnosis of staphylococcal infection is carried out in several ways, but the main one is the isolation of GL from pus or biological fluids. Materials are Gram-stained and examined under a microscope or plated on nutrient media. Normally, blood, urine, cerebrospinal fluid and other biological fluids are sterile, so even a single discharge of GL from them indicates a staphylococcal infection.

The first step is to obtain samples of infected tissue or fluid. The method of obtaining depends on the localization of the infection. For example, in persons with skin infections or infections of the throat, nose, and wound infections, a swab should be taken from the affected area using a sterile swab. In patients with urinary tract infection, urine samples are taken in sterile containers, and in patients with a generalized infection, blood is taken for analysis. Thus, the material for diagnosis is quite diverse. This may be blood, pus, nasal secretions, cerebrospinal fluid, urine, cell aspirates from the blood or lungs.

Symptoms of staphylococcal infection are often caused by toxins secreted by GL, so a culture of an apparently infected lesion may not contain GL, so a diagnosis cannot be made on the basis of culture alone. For this reason, samples from more than one source should be provided, if possible. Diagnosis of staphylococcal infection is carried out by a microscopic, cultural method, PCR diagnostics, enzyme tests, serological diagnosis enzyme-linked immunosorbent assay (ELISA).

Microscopic method

The essence of the microscopic method is the study of pus and biological materials under a microscope with Gram staining. The resulting sample of infected tissue or liquid is applied in a thin layer on a glass slide, then the smear is dried and stained by Gram.

Staphylococci aureus are Gram-positive spherical-shaped bacteria (cocci) with a diameter of about 0.5-1.0 microns. They are present in the form of clusters of purple color, reminiscent of bunches of grapes. Bacteria can also occur in pairs, small groups, short chains, and sometimes in clusters.

Clusters occur because staphylococci divide into 2 planes. This clustering helps distinguish staphylococci from streptococci, which usually grow in chains. In addition to the GL themselves, microscopy almost always reveals large accumulations of neutrophils.

Cultural method

When using the cultural method of research, a sample of infected tissue or biological fluid of the patient is placed on a nutrient medium in a Petri dish, which is a source of energy, nutrition, carbon and nitrogen for the growth of staphylococci. As a nutrient medium, blood agar is used, on which the growth of GL occurs within 18-24 hours, after which yellow or golden-yellow colonies are observed on the media with or without a hemolysis zone.

Mannitol Salt Agar is a selective medium containing 7.5% sodium chloride and is commonly used for the isolation of S. aureus. After inoculation, Petri dishes are incubated at 35°C for 24-48 hours. Staphylococcus aureus is a mannitol-fermenting bacterium and produces yellow or golden colonies on a nutrient medium.

Colonies of Staphylococcus aureus usually produce positive result during catalase, coagulase and thermonuclease tests.

Treatment

The basis of the treatment of staphylococcal infection is the competent selection of antibiotic therapy. The table shows the main types of antibiotics used in the treatment of infections caused by Staphylococcus aureus.

Antibiotics used in the treatment of S. aureus infections:

Before prescribing an antibiotic, it is necessary to analyze the sensitivity of the bacteria to antibiotics, which will help to identify the drug that is most active against a particular strain of GL. In addition, strains of Staphylococcus aureus that are resistant to certain drugs are excluded, since this antibiotic will not be able to eliminate the existing infection.

Antibiotic resistance

Staphylococcus aureus very quickly adapts to various antibiotics, which leads to their ineffectiveness against this microorganism. Moreover, the development of antibiotic resistance in AP is so rapid that it has become a serious medical problem, as many forms of staphylococcal disease caused by it are practically untreatable.

Benzylpenicillin appeared in clinical practice in 1941, but after 4 years strains of S. aureus resistant to it were identified. As it turned out, they synthesized beta-lactamases - enzymes that destroy the beta-lactam ring of penicillins. Many other antibiotics (tetracyclines, macrolides, aminoglycosides) became available in the 1950s, but strains of GL resistant to them have been identified for several years. In the 60s, the antibiotic methicillin appeared on the market, on which great hopes were pinned, but literally a year later, methicillin-resistant strains of GL were discovered.

Methicillin-resistant Staphylococcus aureus is resistant not only to methicillin and other medicines the same class, including penicillin, amoxicillin and oxacillin. This strain first appeared among patients in hospitals and other medical institutions, especially often detected in the elderly, critically ill, and those with open wounds (eg, bedsores) or a catheter. In some hospitals, the percentage of methicillin-resistant strains reaches 40%.

Methicillin-resistant MR infections are usually mild, superficial skin infections, but they are likely to progress to life-threatening blood or bone infections because fewer antibiotics are available for treatment due to resistance to a number of antibiotics. effective drugs. All this requires special attention to such an infection and a thorough analysis of the spectrum of prescribed drugs, taking into account the existing antibiotic resistance.

Complications and prognosis

Scalded skin syndrome is serious complication staphylococcal infection, during which multiple blisters and peeling zones form on the skin. The disease occurs mainly in children, but it can also occur in adults.

A localized staph infection is capable of spreading, resulting in more serious lesions such as endocarditis, osteomyelitis, or meningitis. Another complication of staphylococcal infection is sepsis, which can develop up to life threatening complications - toxic shock syndrome.

The prognosis or outcome of a staphylococcal infection depends on the strain of AP, the degree of spread of the infection, and the patient's health status. Skin infections and superficial infections are usually easily treated with antibiotics. Rarely, these infections can spread and cause complications, including sepsis (spread of the infection into the bloodstream). It is important to remember that even after taking antibiotics, there is a chance of developing a second infection.

Generalized infections such as sepsis have a less favorable prognosis, with mortality from sepsis ranging from 20% to 40%. Before antibiotics were available for treatment, about 80% of people with staph infections died from complications. Patients with suppressed immune systems (immunodeficiencies) are at an increased risk of developing more serious infections.

Staphylococcal food poisoning usually resolves on its own without complications.

How to prevent infection?

Here are some simple precautions you can take to reduce your risk of developing staph infections:

• wash your hands thoroughly- it is necessary to use antiseptic disinfectants containing alcohol for washing hands;
• keep wounds covered- cuts and abrasions should be covered with clean, sterile, dry bandages until they heal; pus from infected wounds often contains staphylococcus bacteria, so covering the wounds prevents the spread of bacteria;
• change tampons frequently during your period- tampons used for a long time can be a breeding ground for staph, so you should change tampons as often as possible and try to alternate tampons with sanitary napkins when possible;
• keep personal items to yourself- it is necessary to avoid sharing personal items, such as towels, razors, clothes, dishes, since Staphylococcus aureus can spread not only from person to person, but also as a result of sharing things;
• clothes and bedding should be washed in hot water- Staphylococcus aureus is able to survive on clothes and bedding that are not washed properly to kill bacteria, they must be washed in hot water;
• observe food safety measures- before handling food, wash your hands, observe the temperature regime for storing food and their expiration dates.

Staphylococcal infection has long been one of the most numerous and widespread in health care. Treatment of staphylococcal infections in some cases is difficult due to the resistance of bacteria to many antimicrobials that has developed in recent years.

Rice. 1. The photo shows Staphylococcus aureus.

Treatment of staphylococcal infection should be directed both to the pathogen itself and to the macroorganism. The treatment regimen is selected strictly individually. Treatment of mild forms of infection is limited to symptomatic therapy. In severe infections, complex therapy is used:

• antibiotic therapy,
• the use of anti-staphylococcal drugs - anti-staphylococcal immunoglobulin, plasma, toxoid and staphylococcal bacteriophage,
• the use of surgical methods of treatment according to the indications,
• detoxification therapy,
• stimulation of the body's defenses.

Newborns and premature babies are hospitalized at the slightest suspicion of the development of a staphylococcal infection.

Good immunity prevents the development of infection and significantly reduces the symptoms of the disease.

Rice. 2. Staphylococcal pyoderma in young children.

Antibacterial drugs

In connection with the multiresistance (resistance) of staphylococci to a whole group of antibiotics that has developed in recent decades staphylococcal infection today treated with modern antibiotics:

• semi-synthetic and penicillinase-resistant penicillins ( Amoxiclav, Naficillin),
• antibiotics of the aminoglycoside group neomycin, kanamycin),
• cephalosporins of the 3rd and 4th generation ( Ceftriaxone, Cefatoxime, Cefepime, Zinnat and etc),
• macrolide antibiotics ( Clarithromycin Azithromycin Josamycin),
• tetracycline antibiotics ( Doxycycline, Unidox-solutab),
• antibiotics of other groups ( Vancomycin, Clindamycin, Lincomycin).
• natural antibiotic Fusidic (fusidic) acid.

Rice. 3. The photo shows pyoderma in older children.

Specific treatment for staphylococcal infection

For the specific treatment of staphylococcal infections, anti-staphylococcal drugs are used, which are represented by anti-staphylococcal immunoglobulin, anti-staphylococcal plasma, staphylococcal toxoid and staphylococcal bacteriophage.

Antistaphylococcal immunoglobulin

Anti-staphylococcal immunoglobulin is a solution containing class G antibodies to a number of pathogenic strains of staphylococcus, including those resistant to penicillin. Get the drug from the serum and plasma of donors. The drug is administered intramuscularly. Its dose and duration of treatment depend on the severity of the disease, the age of the patient and his weight. Indications for the use of antistaphylococcal immunoglobulin in young children are any manifestations of staphylococcal infection. The use of antistaphylococcal immunoglobulin together with antibiotics gives a good result in the treatment of a number of diseases. Severe generalized forms of staphylococcal infection in children, including sepsis, are an indication for intravenous administration hyperimmune antistaphylococcal immunoglobulin.

Rice. 4. The photo shows antistaphylococcal immunoglobulin.

Hyperimmune anti-staphylococcal plasma

One type of specific treatment is the use of hyperimmune antistaphylococcal plasma. The composition of hyperimmune anti-staphylococcal plasma includes anti-staphylococcal antibodies, which have a detrimental effect on bacteria. The drug is administered intravenously several times with an interval of 1-3 days.

Staphylococcal toxoid

Staphylococcal toxoid stimulates the formation of anti-staphylococcal immunity in the patient's body, which is manifested by the production of antibodies against staphylococcal exotoxin.

• Indications for the use of staphylococcal toxoid are acute and chronic staphylococcal infection, manifested in the form of furunculosis, hydradenitis, panaritium, phlegmon, mastitis, gynecological and urological diseases, diseases of the ear, throat and nose.
• The drug is administered for prophylactic purposes to persons whose work is associated with an increased risk of infection with staphylococci - workers in industrial enterprises and agriculture.
• The drug is administered to donors in order to obtain antistaphylococcal plasma and antistaphylococcal immunoglobulin.

Staphylococcal toxoid is administered subcutaneously every 1-2 days in increasing dosage and is indicated for use only by adults.

Rice. 5. The photo shows staphylococcal toxoid and staphylococcal bacteriophage. The drugs are widely used as a specific treatment for staphylococcal infections.

Staphylococcal bacteriophage

Staphylococcal bacteriophage has the ability to destroy Staphylococcus aureus. Bacteriophages ("eaters") are viruses that destroy bacterial cells. Staphylococci are able to develop resistance to bacteriophages, therefore, before using the drug, the sensitivity of phages to pathogens should be determined.

Staphylococcal bacteriophage is used for diseases of the nasopharynx, upper and lower respiratory tract, gastrointestinal tract, surgical and urogenital infections, pyoinflammatory diseases of newborns and infants, including sepsis.

• Staphylococcal bacteriophage is used in the form of a solution and ointment for irrigation and lotions, in the form of tampons and lubrication of the affected areas. The drug is injected into the lesion, used for chipping the lesion, injected under the base of the inflammatory infiltrates.
• With deep pyoderma, a staphylococcal bacteriophage is injected intradermally.
• Staphylococcal bacteriophage can be injected into the abdominal and pleural cavities, into the joints and the bladder cavity.
• With staphylococcal lesions of the intestine and dysbacteriosis, the staphylococcal bacteriophage is applied through the mouth and injected directly into the rectum in liquid form or suppositories.

Rice. 6. Figure 8 and 9. The photo shows a bacteriophage (left) and a schematic representation of a bacteriophage (right).

Non-specific methods to increase the body's defenses

In addition to specific methods of treating staphylococcal infection, autohemotherapy, the introduction of protein blood substitutes, pyrogenal, prodigiosan, methyluracil and splenin are indicated. Vitamin therapy and the use of immunomodulators are shown. To stimulate the immune system in children and adults, the use of drugs is indicated. plant origin- echinacea ( Immunal), ginseng ( ginseng tincture, preparations in the form of tablets and capsules) and Schisandra chinensis.

Rice. 7. In the photo there is a boil on the face.

Detoxification therapy

Detoxification therapy is always used in the treatment of staphylococcal infections in children. The introduction of such blood substitutes as hemodez and neocompensan is widely used. In severe cases, a direct blood transfusion is performed from previously immunized parents.

Physiotherapy

In the treatment of staphylococcal infections good effect gives the use of physiotherapy methods in the form of ultraviolet irradiation, UHF currents, electrophoresis with anti-inflammatory drugs and a helium-neon laser.

Treatment of superficial pyoderma

With staphylloderma, the inflammatory process is localized in the area of ​​​​sebaceous hair follicles (ostiofolliculitis, superficial folliculitis, sycosis vulgaris and epidemic pemphigus of newborns).

Treatment of superficial pyoderma includes the use of antiseptics and the opening of flickten tires (superficial vesicles with purulent contents).

• It is recommended to lubricate the affected surface alcohol 1% salicylic solution or camphor alcohol, use aniline dyes: fucorcin solution (Castellani liquid), brilliant green solution (brilliant green).
• If necessary, the tire is opened conflict and pustules. After opening, the affected areas of the skin are washed 3% hydrogen peroxide solution and lubricated with disinfectant furacillin solution or alcohol solution of iodine.
• Extensive areas of skin lesions are lubricated with ointments containing antibiotics - Fusidin, Bactroban or Heliomycin ointment.
• Unaffected skin around the abscesses is smeared 2% solution salicylic acid or 0.1% potassium permanganate solution.
• Has good regenerative abilities Ichthyol ointment, Iruksol, Levomikol, Curiosin solution.

Rice. 8. In the photo, folliculitis is superficial on the face and lower limbs.

The use of surgical methods of treatment for staphylococcal infections

The goal of surgery for staphylococcal infection is to open the abscess and ensure a good outflow of purulent-inflammatory exudate. Opened abscesses are washed with antibiotic solutions and drained. Proteases are widely used - enzymes that are able to cleave peptide bonds in proteins and decay products, thereby accelerating the cleansing of purulent wounds.

With, carbuncles and hidradenitis, only surgical treatment is used. Subsequently, the above conservative methods are applied.

Rice. 9. In the photo there are carbuncles on the neck. On the right, an opening of the carbuncle on the neck.

Rice. 10. The photo shows the surgical treatment of carbuncle. When opening the abscess, a cruciform incision is made.

Rice. eleven. Surgery staphylococcal infection. Opened abscesses are washed with antibiotics and drained.

Treatment of staphylococcal gastroenteritis and enterocolitis

With staphylococcal gastroenteritis and enterocolitis, newborns and children of the first year of life are hospitalized and placed in a separate box. If the child stays at home, then medical supervision and good care are organized for him.

• The basis of the treatment of gastroenteritis is antibiotic therapy. Staphylococci are sensitive to drugs of the group of aminoglycosides, tetracyclines, cephalosporins of the 3rd and 4th generations, macrolides.
• A special positive effect in the disease is given by treatment with bacteriophages.
• The basis of pathogenetic therapy is measures to combat intoxication and replenish the volume of lost fluid and minerals.
• Symptomatic therapy is aimed at eliminating pathological syndromes diseases.
• Treatment of children and pregnant women begins with the appointment of bacteriophages and probiotics. In case of their ineffectiveness, a transition to antibacterial treatment is carried out.

Sepsis treatment

Acute sepsis, abscess destructive pneumonia and meningoencephalitis are direct indications for the appointment of two antibiotics at the maximum age dosage. The greatest effect is achieved by their intravenous administration.

Rice. 12. The photo shows destructive pneumonia. The cause of destruction (in this case, an abscess) is often staphylococci.

Staphylococcal infection has long been one of the most numerous and widespread in health care. Staphylococcus infects the skin and subcutaneous tissue, oral cavity and respiratory tract, digestive tract, membranes of the brain and joints, causes sepsis and severe toxicosis. The greatest danger to humans is Staphylococcus aureus. Treatment of staphylococcal infection is complex and strictly individual. Its basis is the use of antimicrobial drugs (antibiotics, staphylococcal bacteriophage and toxoid, antistaphylococcal immunoglobulin and plasma, etc.). Good immunity is the best defense against infection.

Staphylococcus aureus(lat. Staphylococcus) is a motionless spherical bacterium belonging to the Staphylococcal family (Staphylococcaceae).

Staphylococcus belongs to the group of positive, immobile, anaerobic, conditionally pathogenic microorganisms for the human body. The type of metabolism is oxidative and enzymatic. Spores and capsules do not form. Staphylococcus cell diameter is 0.6-1.2 microns, depending on the strain (species). The most common colors are purple, gold, yellow, white. Some staphylococci are able to synthesize characteristic pigments.

Most species of staphylococcus aureus are purple in color and spread in bunches similar to grapes, which is why they got their name, which in ancient Greek means "σταφυλή" (grapes) and "κόκκος" (grain).

Staphylococci in a certain amount are almost always found on the surface of the human body (in the nasopharynx and oropharynx, on the skin), but when this infection gets inside, it weakens the body, and some types of staphylococcus can even cause the development of various diseases, and almost all organs and systems, especially if the immune system is weakened. The fact is that staphylococcus, getting inside, produces a large amount of endo- and exotoxins (poisons), which poison the cells of the body, disrupting their normal functioning. The most common pathologies that cause staphylococci are pneumonia, toxic shock, sepsis, purulent skin lesions, disturbances in the functioning of the nervous, digestive and other systems, and general poisoning of the body. Not a rare case is the addition of a staphylococcal infection, as a secondary disease, as a complication in others.

The conditional pathogenicity of this type of infection suggests that staphylococci act negatively on human or animal health only under certain conditions.

There are a fairly large number of staphylococcus species - 50 (as of 2016). The most common are Staphylococcus aureus, hemolytic, saprophytic and epidermal staphylococci. Each of the strains of these bacteria has its own severity and pathogenicity. They are resistant to many antibacterial drugs, as well as various harsh climatic conditions, but are sensitive to aqueous solutions of silver salts and its electrolytic solutions.
Staphylococcal infection is widespread in soil and air. It is by air that the infection (infection) of a person most often occurs. It is also worth noting that this species infection can affect not only people, but also animals.

It has been noticed that children are most susceptible to staphylococcus infection, which is associated with an immature immune system and non-observance of personal hygiene rules, as well as elderly people.

Causes of staphylococcus aureus

The cause of the development of almost all staphylococcal diseases is a violation of the integrity of the skin or mucous membranes, as well as the use of contaminated food. The level of harm also depends on the strain of bacteria as well as the functioning of the immune system. The stronger the immune system, the less harm staphylococci can cause to human health. Thus, we can conclude that in most cases, a combination of 2 factors is necessary for the disease of staphylococcus aureus - ingestion of the infection and disruption of the normal functioning of the immune system.

How is staphylococcus transmitted? Consider the most popular ways of contracting a staphylococcal infection.

How can staphylococcus enter the body?

Airborne route. In season respiratory diseases, frequent stay in crowded places also increases the risk of infection, not only staphylococcal, but also many other types of infection, incl. viral, fungal. , cough - these symptoms serve as a kind of beacons, from which healthy people If possible, stay away.

Air-dust path. Household and street dust contains a large number of various microscopic particles - plant pollen, desquamated skin particles, the hair of various animals, dust mites, particles various materials(fabric, paper), and all this is usually seasoned with various infections - fungi. Staphylococcus and other types of infection are very often found in dust, and when we breathe such air, it does not affect our health in the best way.

Contact-household way. Usually, infection occurs when sharing personal hygiene items, bed linen, especially if one of the family members is sick. The risk of infection increases with injury to the skin, mucous membranes.

Fecal-oral (alimentary) route. Infection occurs when eating food with dirty hands, i.e. - in case of non-compliance. It is also worth noting here that infection by the alimentary route is also common cause diseases such as -, and other complex ones.

medical path. Infection with staphylococcus occurs through contact with insufficiently clean medical instruments, as in surgical interventions, and with some types of diagnostics, which imply a violation of the integrity of the skin or mucous membranes. This is usually due to the treatment of instruments with an agent to which staphylococcus has developed resistance.

How can staph seriously harm a person's health, or what weakens the immune system?

The presence of chronic diseases. Most illnesses are indicative of a weakened immune system. If pathological processes are already taking place in the body, it is more difficult for it to defend itself against other diseases. Therefore, any disease increases the risk of a secondary infection joining it, and staphylococcal is one of them.

The most common diseases and pathological conditions in which staphylococcus often attacks the patient are: tonsillitis, pharyngitis, laryngitis, tracheitis, bronchitis, pneumonia, diseases and other systems, as well as other chronic diseases.

In addition, the risk of infection with staphylococcus increases:

• Bad habits: smoking, drinking alcohol, using drugs;
• , lack of healthy sleep;
• Sedentary lifestyle;
• Use ;
• (deficiency of vitamins);
• Abuse of some medicines- vasoconstrictors (violate the integrity of the nasal mucosa), antibiotics;
• Violations of the integrity of the skin, mucous membranes of the nasal cavity and mouth.
• Insufficient ventilation of rooms in which a person often stays (work, home);
• Work at enterprises with high air pollution, especially without protective equipment (masks).

Staphylococcus symptoms

The clinical picture (symptoms) of staphylococcus can be very diverse, depending on the affected organ, the strain of bacteria, the age of the person, the functionality (health) of the potential patient's immunity.

Common symptoms of staphylococcus can be:

• Increased and heat bodies (often local) - up to , ;
• (rush of blood to the site of inflammatory processes);
• General malaise, soreness;
• puffiness;
• Pyoderma (develops when staphylococcus gets under the skin), folliculitis, carbunculosis,;
• Decreased appetite,;
• - , and ;
• Respiratory tract diseases:, and;
• Purulent discharge from the nasopharynx and oropharynx of a yellow-green color;
• Violation of the sense of smell;
• Difficulty breathing, sneezing;
• Changing the timbre of the voice;
• Toxic shock syndrome;
• drop in blood pressure;
• "Scalded Baby Syndrome";
• Violations of the functioning of some organs and tissues, which have become the focus of infection;

Complications of staphylococcus:

• lung abscess;
• Pleural empyema;
• loss of voice;
• convulsions;

Scientists have identified most types of staphylococcus in 11 groups:

1. Staphylococcus aureus (Staphylococcus aureus)- S. aureus, S. Simiae.

Staphylococcus aureus is the most pathogenic human body. Once inside, they are able to cause inflammatory processes and damage to almost all human organs and tissues, as well as to form a golden pigment. Staphylococcus aureus has the ability to produce the enzyme coagulase, which is why it is sometimes called coagulase-positive staphylococcus aureus.

2. Ear staphylococci (Staphylococcus auricularis)- S. auricularis.

3. Staphylococcus carnosus- S. carnosus, S. condimenti, S. massiliensis, S. piscifermentans, S. simulans.

4. Epidermal staphylococci (Staphylococcus epidermidis)- S. capitis, S. caprae, S. epidermidis, S. saccharolyticus.

Epidermal staphylococcus is most often found on the skin and mucous membranes of a person. It is a common cause of diseases such as -, endocarditis, sepsis, purulent lesions of skin and urinary tract wounds. With the normal functioning of the immune system, the body does not allow epidermal staphylococci to multiply inside the body and infect it.

5. Hemolytic staphylococci (Staphylococcus haemolyticus)- S. devriesei, S. haemolyticus, S. hominis.

Hemolytic staphylococcus is most often the cause of such diseases as - endocarditis, sepsis, inflammatory processes with suppuration on the skin, and.

6. Staphylococcus hyicus-intermedius- S. agnetis, S. chromogenes, S. felis, S. delphini, S. hyicus, S. intermedius, S. lutrae, S. microti, S. muscae, S. pseudintermedius, S. rostri, S. schleiferi.

7. Staphylococcus lugdunensis— S. lugdunensis.

8. Saprophytic staphylococci (Staphylococcus saprophyticus)– S. arlettae, S. cohnii, S. equorum, S. gallinarum, S. kloosii, S. leei, S. nepalensis, S. saprophyticus, S. succinus, S. xylosus.

Saprophytic staphylococcus is often the cause of urinary tract diseases such as cystitis and urethritis. This is due to the fact that saprophytic staphylococcus aureus is located mainly on the skin of the genitals, as well as the mucous membranes of the urinary tract.

9 Staphylococcus sciuri– S. fleurettii, S. lentus, S. sciuri, S. stepanovicii, S. vitulinus.

10 Staphylococcus simulans– S. simulans.

11. Staphylococcus warneri– S. pasteuri, S. warneri.

Degrees of staphylococcus

To determine the exact treatment regimen, doctors divided the course of staphylococcal disease into 4 conditional degrees. This is due to the fact that different kinds infections, as well as their pathological activity at different times and under different conditions, differ. In addition, this approach to diagnosis distinguishes between a staphylococcal infection, to which group it belongs - a completely pathogenic effect on the body, conditionally pathogenic and saprophytes, which practically do no harm to a person.

Degrees of staphylococcus

Staphylococcus 1 degree. Localization of infection for sampling for diagnosis - nasopharynx and oropharynx, skin, genitourinary system. Clinical manifestations absent or minimal. With a healthy immune system, drug therapy not required.

Staphylococcus 2 degree. Clinical manifestations (symptoms) are minimal or absent. If there are complaints, a thorough diagnosis is carried out for the presence of other types of infection. If it is established that another type of bacteria is also present in the body, antibiotic therapy is privately prescribed.

Staphylococcus 3 degree. The patient has complaints. In most cases, antibiotic therapy is necessary, except in a situation in which the attending physician considers that the use of antibiotics is unreasonable. Treatment of grade 3 staphylococcus is usually aimed primarily at strengthening the immune system. If within 2 months, recovery by the forces of the body does not occur, an individual treatment regimen for the infection is developed, incl. with the use of antibacterial agents.

Staphylococcus 4 degree. Therapy is aimed at strengthening immunity, eliminating,. Before using antibiotic therapy, a thorough diagnosis is carried out for the reaction of a particular type of staphylococcus to the drug.

Diagnosis of staphylococcus

Testing for staphylococcus aureus is done from swabs, usually taken from the surface of the skin, mucous membranes of the upper respiratory tract, or urinary tract.

Additional methods of examination can be:

How to treat staphylococcus aureus? Treatment of staphylococcus usually consists of 2 points - strengthening the immune system and antibiotic therapy. In the presence of other diseases, their treatment is also carried out.

It is very important to use antibiotics on the basis of diagnosis, since it is necessary to determine the type of staphylococcus by clinical picture practically impossible, and the use of broad-spectrum antibiotics can cause a large number of side effects.

However, the following most popular antibiotics are used to treat staphylococcus aureus.

Antibiotics for staphylococcus aureus

Important! Before using antibiotics, be sure to consult your doctor.

"Amoxicillin". It has the property of suppressing infection, stops its reproduction and negative effects on the body. Blocks the production of peptidoglycan.

"Baneocin". Ointment for the treatment of staphylococcus with skin lesions. It is based on a combination of two antibiotics - bacitracin and neomycin.

"Vancomycin". Contributes to the death of bacteria, due to the blocking of the component that is part of its cell membrane. It is applied intravenously.

"Claritomycin", "Clindamycin" and « » . They block the production of their proteins by bacteria, without which they die.

"Cloxacillin". It blocks the multiplication of staphylococcus by blocking their membranes present at the stage of their cell division. Usually prescribed at a dose of 500 mg / 6 hours.

"Mupirocin"- antibacterial ointment staphylococcal lesions skin. Used for external use. The basis of the ointment are three antibiotics - baktroban, bonderm and supirotsin.

"Oxacillin". Blocks the division of bacterial cells, thereby destroying them. Method of application - oral, intravenous and intramuscular.

- In hot weather, avoid eating confectionery, meat, dairy and other products that are not stored in proper conditions;

- In case of injury to the skin, be sure to treat the wound with antiseptic agents, then cover it with a band-aid;

- Try not to visit beauty salons, tattoo parlors, tanning salons or dental clinics of a dubious nature, where they may not adhere to sanitary standards for the processing of medical instruments.

Which doctor should I contact with a staphylococcal infection?