Staphylococcal Infections (pneumonia)

Staphylococcal Infections

pneumonia

Staph. pyogenes (coagulase-positive staphylococcus – syn. Staph. aureus) is responsible for a wide variety of suppurative conditions such as infected lacerations, styes, boils, carbuncles, abscesses, osteomyelitis, pneumonia, necrotizing enterocolitis and bacteraemia with pyaemic abscesses. Infection is derived from human or sometimes animal sources and the organisms can be grown from the nasopharynx and skin of up to 30% of healthy persons. The staphylococcus is readily spread from these sites and from clothing to contaminate the dust in which it survives in the dry state for weeks or months.

(pneumonia)

(pneumonia) In hospital this organism is an important cause of wound infection, pneumonia and neonatal sepsis. Under suitable conditions it multiplies freely in food and milk and so is an important cause of food poisoning. However many infections, particularly boils, carbuncles and abscesses, are due to autogenous infection.
Strains of Staph. pyogenes resistant to antibiotics have increased in number since these drugs were introduced. Such strains are more commonly acquired in hospital and may give rise to small epidemics of infection. Elsewhere the majority of strains are sensitive to antistaphylococcal antibiotics although the production of penicillinase by many precludes treatment with benzylpenicillin. Necrotising enterocolitis is usually the result of the unrestricted growth of drug-resistant staphylococci in the gut following the suppression of other organisms by chemotherapy. The diarrhea, dehyderation and peripheral circulatory failure may be so severe as to resemble cholera.

(pneumonia) Boils

are satisfactory treated with an occlusive dressing or the local application of antiseptic agents. When the severity of the disease warrants antibiotic therapy, the choice depends on whether the infection has been acquired inside or outside hospital. In the later case the organism may be sensitive to penicillin. If the therapeutic response is not satisfactory within 48 hours, the sensitivity tests should be carried out. Since the majority of staphylococcal infections acquired in hospital are resistant to the commonly used antibiotics, the organism should be submitted to sensitivity tests at the outset. If the patient is seriously ill treatment should be commenced with cloxacillin, unless the patient is known to be allergic to the penicillins when lincomycin or clindamycin should be given. All possible care must be taken to prevent the spread of staphylococcal infection and infective patients should be isolated and barrier-nursed. (Staphylococcal Infections (pneumonia)