Infections caused by pathogenic staphylococcus, belong to a special group. The fact is that staphylococcus is opportunistic, almost always dwelling on the human body, a widespread microbe in nature. One way or another, a person contacts him daily.
Staphylococcus can cause inflammation of almost any system and any organ – the skin and subcutaneous tissue, internal organs, nervous tissue, brain and heart. Toxins of certain types of staphylococcus give the clinic food poisoning.
For a person of particular importance in the pathogenesis of diseases play three types:
- Staphylococcus aureus, which causes infections in adults and children in almost any organ of the body, on the skin, mucous membranes, and even in nervous tissue.
- Staphylococcus is an epidermal, most dangerous in premature, weak children, and in patients with immunodeficiencies and oncological diseases.
- saprophytic staphylococcus, is of great importance in urinary tract infection.
Each of the types of staphylococcus has many strains (varieties) that differ from each other in the degree of aggressiveness and pathogenicity.
Depending on the strain, certain types of staphylococcus selectively affect certain organs.
The cause of staphylococcal infections is the infection of a person with pathogenic staphylococcal strains (for example, nosocomial infection) or staphylococcus entering into those organs where it should not be under normal conditions. Staphylococcus is highly resistant to the environment, stored for half a year in a dried, frozen state, lives well in water and food, is not afraid of the sun’s rays.
Staphylococcus is able to excrete exotoxins that affect the skin or white blood cells (leukocytes), enterotoxins that affect the digestive system, and cause symptoms of poisoning.
Also, staphylococcus secretes special substances that suppress the immune mechanisms of the body, which helps germs to actively reproduce in the body.
The source of infection is a healthy carrier of staphylococcus (for example, parents for a child), or a patient with a staphylococcal infection of any form ( streptoderma , pneumonia, purulent staphylococcal mastitis). Up to 40% of people, one way or another, are infected with staphylococcus.
Nosocomial staphylococcal infection is dangerous, as these strains are usually aggressive, resistant to antibiotics and highly infectious. Infection occurs:
- by contact, from person to person in bodily contact and the use of common things and hygiene items (as, for example, in postpartum mastitis),
- by airborne droplets, especially for nosocomial pneumonia,
- by food (during outbreaks of staphylococcal gastroenteritis),
- through the hands of personnel who are carriers of pathogenic staphylococcus.
Especially important factors in the development of infections are:
- reduced immunity
- use of strong medicines, immunosuppressants,
- chronic pathologies,
- thyroid problems
- stresses, environmental impact.
Staphylococcal infections are especially difficult in young children and in the elderly.
Immunity to staphylococcus is unstable, it is possible to recover many times. Specific immunization has not been developed for it.
Symptomatology will depend on where the staphylococcus will invade and multiply, in addition, the manifestations depend on the strain and aggressiveness of the staphylococcus.
Staphylococcus can affect almost all systems, tissues and organs, giving the clinic local staphylococcal or common diseases. The skin, subcutaneous tissue, nervous system, kidneys, liver, lungs, urinary system, bone tissue and general infection of the body (sepsis) can be affected.
Skin lesions – pyoderma, pustular lesions, occur as a result of damage to the mouth of the hair bulb. Small lesions are called folliculitis , deeper with damage to the fiber – boils, purulent fusion of hair follicles. At defeat of hypodermic cellulose there are carbuncles. Most often they occur on the neck, buttocks and thighs, on the face.
Ritter’s disease or “scalded” skin is a staphylococcal lesion in newborns with bright red skin and flaking.
With pemphigus strained large blisters with serous contents are formed on the skin. Occurs under the influence of staphylococcal toxins.
Cellulitis and abscess occur in deep tissues, being limited or widespread purulent tissue damage. When abscess pus is limited to the capsule, when cellulitis spreads between the tissues, which can lead to dangerous lesions.
Pneumonia of staphylococcal etiology is very difficult, giving a massive lung damage, resistant to therapy and often fatal.
There is severe intoxication, chest pain, shortness of breath. Multiple purulent foci form in the lungs with the formation of abscesses.
When staphylococcus penetrates, abscesses and purulent meningitis are formed from the primary lesions in the brain.
These complications are severe and life-threatening, are difficult to treat and leave residual (lifelong) consequences, often leading to disability.
Manifest fever, headaches, vomiting, toxicosis, neurological symptoms. Staphylococcal thrombophlebitis of the brain veins can be the cause of strokes.
Staphylococcus can affect the bone tissue with the formation of osteomyelitis , at the same time all layers of bone are destroyed, pathological fractures, fistula and pain in the affected bones occur, there may be lesions of the joints with purulent arthritis.
Severe staphylococcal mastitis endocarditis, pyelonephritis are also possible, and staphylococcal sepsis is the most severe lesion.
The basis of the diagnosis is a clinical picture and serological methods, the main of which are the coagulase test and latex agglutination.
The standard coagulase test in a test tube lasts 4 hours, but with a negative result it is prolonged for a day.
Latex agglutination uses commercial sets of latex particles associated with antibodies to staphylococcus (A-protein, adhesion factor and a number of surface antigens), which makes it also useful for specific and strain identification of the pathogen.
It is important to sow the pathogen with the definition of sensitivity to antibiotics (methicillin), since staphylococci can be resistant to most traditional therapies.
Additional for the diagnosis will be a general analysis of blood and urine, biochemical analyzes and other methods of research, depending on which organs are affected – x-rays in pneumonia and osteomyelitis, ultrasound in liver and kidney damage, etc.
The basis of treatment is the fight against the pathogen and the elimination of the consequences of its vital activity.
For purulent wounds and abscesses, the basis of treatment is surgical opening of ulcers, with further washing with antibiotics and drainage.
Staphylococci are treated with the use of modern antibiotics of the new generation due to their multiresistance (insensitivity) to their usual antibiotics.
- semi-synthetic and protected penicillins (amoxiclav, naficillin),
- aminoglycosides (neomycin, kanamycin),
- some other types (vancomycin, clindamycin, ofloxacin).
For staphylococcus, one of the methods of treatment is phage therapy. These are special “devourers” of staphylococcus, specific viruses that selectively kill exactly staphylococci, for example, an anti-staphylococcal bacteriophage liquid. For external treatment used ointment with antimicrobial components, antiseptics.
In case of a staphylococcal infection, the use of immunomodulators and immunity enhancing agents is extremely important. Anti-staphylococcal immunoglobulins, hyperimmune plasma, autohemotherapy, etc. are used. Multivitamins, heavy drinking and detoxification are used.
Projections for staphylococcal infections are largely dependent on the type of staphylococcus and its strain, on the severity of the lesion and focus, the age of the patient and the resistance of the microbe to antibiotics.
With nosocomial infection, the prognosis can be unfavorable, even lethal due to the high resistance of microbes to antibiotics and the high aggressiveness of the pathogen.
Today, staphylococcal infection is one of the leading causes of the development of purulent-septic complications in debilitated, operated patients and young children, especially newborns and premature infants.