Staphylococcus Aureus
Staphylococcus Aureus
Diagnostic and Treatment

Staphylococcus Aureus

What is Staphylococcus Aureus

Staphylococcus Aureus

Staphylococcus aureus was first described in 1884 by Rosenbach in this scientific name. He described this time two pigmented colony types of Staphylococcus and named in accordance with the Staphylococcus aureus (large, golden-yellow colonies) and Staphylococcus albus (small, white colonies). S. albus now bears the scientific name of S. epidermidis.
Staphylococcus Aureus is a facultative anaerobic Gram-positive coccal bacterium, also known as "golden staph". Typically in a heap or a cluster: Arrange (Greek Staphylos), 0.8 to 1.2 microns in size. The bacterium is immobile and does not form spores, some strains, however, have a capsule. The greatest clinical significance of the bacterial species Staphylococcus aureus, coagulase.

Staphylococcus Aureus Syndromes

Staphylococcus Aureus syndromes

The infections caused by S. aureus can be divided into invasive and toxin-mediated disease processes. Localized invasive processes include boils (when confluent "carbuncles"), pyoderma, wound infections, sinusitis and otitis media. Deeper infections are suppurative parotitis, puerperal mastitis, and the primary and secondary (post-operative or post-traumatic) osteomyelitis. The S. aureus pneumonia usually occurs in the port on to an influenza A infection or nosocomial pneumonia in mechanically ventilated patients. Abscesses may occur in both soft tissue and in organs, body cavities and joints in empyema. All processes can give rise to germ washout into the bloodstream by itself and thus lead to sepsis and endocarditis.

Food intoxications are caused by the ingestion of enterotoxins, produced by S. aureus before food in contaminated food. The enterotoxins are not killed by heat treatment.

Staphylococcus Aureus diagnosis

In determining the antibiotic sensitivity of the detection of oxacillin (methicillin) is resistant S. aureus (MRSA) is of great importance. The resistance mechanism is based on the presence of an additional penicillin-binding protein (PBP 2a), which is encoded by the mecA gene and has only low affinity for penicillins. Simultaneously, the sensitivity to other beta-lactam antibiotics is lowered so that cross-resistance results against all current members of this group of substances (penicillins, cephalosporins, carbapenems). MRSA in Germany increasingly dar. a problem

Staphylococcus Aureus antibiotic therapy

image Staphylococcus Aureus

For a calculated therapy (in the presence of susceptibility testing) have been long time penicillinasefesten Isoxazolylpenicilline (eg flucloxacillin, STAPHYLEX others) and cephalosporins of the 1st or 2 Generation (eg, cefazolin, ELZOGRAM etc.) used. Here, the cephalosporins offer due to the lower protein binding, pharmacokinetic advantages. At a high prevalence of MRSA is vancomycin (VANCOMYCIN CP and others) the treatment of choice. Severe S. aureus infections should not only be initially treated with an antibiotic. Combinations such as effective cephalosporin + rifampicin (RIFA, etc.), clindamycin (Sobelin etc.) or an aminoglycoside or glycopeptide + rifampicin for MRSA have been found.

For the therapy of MRSA infections are the glycopeptides the first choice. Alternatively, is a therapy with the oxazolidinone linezolid (Zyvox) or Streptograminkombination quinupristin / dalfopristin (Synercid) into consideration. Rifampicin and fusidic acid (Fucidin) may be applied because of the rapid development of resistance only in combination with another antibiotic effective MRSA. Fosfomycin (INFECTOFOS) comes as an alternative for the treatment of S. aureus osteomyelitis considered.

Fusidic acid500 mgs - 1 g2-3 times a day after a meal for 5-10 days
Lysates of bacteria [Haemophilus influenzae B + Klebsiella ozenae + Klebsiella pneumoniae + Moraxella satarrhalis + Staphylococcus aureus + Streptococcus pneumoniae]20-30 ml2-3 times a day for 10-14 days
MupirocinIntranasally.Apply to the affected area up to 3 times a day for 10 days.
Levofloxacin250 - 750 mgsonce a day
Moxifloxacin400 mgsonce a day intravenously
Linezolid400 - 600 mgstwice a day for 10-14 days ( enterococcal infections - 600 mgs for 14 - 28 days)
Norfloxacin400 mgstwice a day for 7-14 days
Grepafloxacin400 - 600 mgsonce a day for 7 - 10 days
Roxithromycin300 mgsonce or twice a day
Ciprofloxacin500 mgstwice a day for 7 - 14 days
Cefepime500 mgs - 1 gtwice a day for 7 - 10 days
Doxycycline200 mgs at first day, 100 mgs at other days5 - 10 days
Vancomycin500 mgs - 1 g500 mgs every 6 hours, 1g every 12 hours
Tobramycin1 mgs/kg1-3 times a day for 5 - 10 days
CefazolinIntramuscular, intravenous. 1-4 g / day (max - 6 gramm a day)2-3 times a day for 7-10 days
Cefotaxime1 - 2 gevery 8 - 12 hours
Fosfomycin3 g at 2 hour before a meal at night1 - 2 times
Lomefloxacin400 mgs (up to 600-800 mgs)twice a day for 10 - 14 days
Clindamycin150-450 mgs3-4 times a day for 10-14 days
Rifampicin450 - 900 mgsonce a day at 1 hour before a meal for 7 - 10 days
Ceftriaxone1 - 2 g once a daynot more than 10 days. The introduction of the drug is recommended to continue for another 2-3 days after normalization of body temperature and symptoms disappear.
Nitroxoline100 mgs (max daily dose - 800 mgs)4 times a day during a meal for 2-3 weeks.
PiperacillinIntramuscular, intravenous. 2 - 4 g every 6-12 hours7 - 10 days
Ceftazidime1 - gevery 8 hours at least 5 days
Cefoperazone2 - 4 g (max 8 g)at least 10 days
Azithromycin250 - 500 mgsonce a day at least 1 hour before or 2 hours following a meal
CefamandoleIntramuscular, intravenous. 0,5-1 g (max daily dose - 12 g)3-6 times a day for 10-14 days.
Cefpodoxime100 - 200 mgstwice a day for 10-14 days.
Mafenide1,5-2 mm layer of ointment or cream1 - 5 weeks
Meropenem500 mgs - 1 gevery 8 hours
Oxolinic acid500 mgs - 1 g4 times a day for at least 7 days.
Nifuratel600 mgs - 1,2 g2-3 times a day for 7-14 days
Pipemidic acid400 mgs2-3 times a day (at morning and night) for 10 days and more
CeftizoximeIntramuscular, intravenous. 1-2 gevery 8 - 12 hours
Erythromycin250 - 500 mgs4 times a day at least 2 hours before a meal
CefuroximeIntramuscular, intravenous. 750-1500 mgs3-4 times a day for 5 - 10 days and more
TryiodinerezorcineApply a thin layer to affected skin1-3 times a day for 1-4 weeks
StreptomycinIntramuscular. 15 mgs / kg /day (max 2 gramm a day) for 7-10 (no more than 14) days.
Benzalkonium chlorideApply at the rate of 0.2-0.4 g/cm2 wound surface (max 50 gramm a day)for 14 days.
PicloxydineConjunctival, 1 drop in affected eye2-6 times a day for no more than 10 days.
FenticonazoleVaginally. Cream 2% (approximately 5 g) was injected deep into the vagina one time a day, evening, or if necessary - 2 times a day (morning and evening). Treatment for up to a full clinical recovery (usually 3-6 days). A second course - in 10 days.
Brilliant greenExternally applied to the affected area, covering the surrounding healthy tissue