Diagnosis and treatment of staphylococcal infection

Diagnosis of staphylococcal infection

Staphylococcal infection is diagnosed on the basis of detection of purulent foci of inflammation. Determining the pathogenic staphylococcus in the lesion, and especially in the blood, is crucial. For serological diagnosis, RA with autostam and a museum strain of staphylococcus are used. The increase in the antibody titer in the dynamics of the disease undoubtedly points to its staphylococcal nature.

The titer of agglutinins in RA 1: 100 is considered diagnostic. Diagnostic titers are detected on the 10-20th day of the disease.

In a complex of laboratory methods, the neutralization of toxin with an antitoxin is used. Increasing the titre of antistaphylolysin and antitoxin also indicates the staphylococcal nature of the disease. However, these reactions give a less accurate result in newborns and prematurity. Currently, traditional methods are replaced by PCR, ELISA, latex agglutination method.

Treatment of staphylococcal infection

With mild forms of localized staphylococcal infection, symptomatic therapy is usually sufficient.

In severe and moderate forms, complex therapy is used: antibiotics and specific anti-staphylococcal drugs (human immunoglobulin antistaphylococcal, antistaphylococcal plasma, staphylococcal anatoxin, staphylococcal bacteriophage, staphylococcal bacterial vaccine). The indications are surgical methods of treatment, nonspecific detoxification therapy, vitamin therapy. To prevent and treat dysbiosis, use bacterial drugs (acipol, bifystim, bifidumbacterin, bifikol dry, etc.), as well as stimulating therapy, which increases the protective mechanisms of the body (tactivin).

Mandatory hospitalization is subject to patients with severe forms of staphylococcal infection, regardless of age. Newborn and especially premature babies are hospitalized and with mild manifestations of staphylococcal infection.

Of antibacterial drugs, semi-synthetic penicillin-resistant penicillins, cephalosporins of III and IV generations are preferable.

In acute sepsis, abscessed destructive pneumonia, meningoencephalitis is prescribed simultaneously two antibiotics at the maximum doses. The most effective is their intravenous administration.

Specific anti-staphylococcal agents

• With all severe and generalized forms of staphylococcal infection, an antistaphylococcal human immunoglobulin is used . This drug contains not only anti-staphylococcal agglutinins, but also antitoxin, it is administered intramuscularly at a dose of 5-6 AE / kg per day daily or every other day, for a course of 5-7 injections. At present, an antistaphylococcal human immunoglobulin is produced for intravenous administration, which is recommended for use in sepsis and other severe generalized forms of staphylococcal infection.
• Hyperimmune antistaphylococcal plasma contains anti- staphylococcal antibodies (antitoxin) and has a bactericidal effect on staphylococcus aureus. Enter intravenously with an interval of 1-3 days to 5-8 ml / kg (not less than 3-5 times).
• Staphylococcus ana toxin is used to stimulate the production of a specific staphylococcal antitoxin. It is indicated in cases of prolonged course of pneumonia, sepsis, enterocolitis, recurrent staphyloderma, furunculosis and other diseases, when the body's ability to immunogenesis is particularly inhibited. Anatoxin is administered subcutaneously in increasing doses (0.1-0.2-0.3-0.4-0.6-0.8-1.0 ED) with an interval of 1-2 days.

The general principles of treatment of staphylococcal gastroenteritis and enterocolitis are the same as those of other acute intestinal infections. Patients are hospitalized for clinical and epidemiological indications.

In case of food poisoning in the first day of the disease, it is necessary to rinse the stomach with 2% sodium bicarbonate solution. In severe toxicosis with dehydration, first perform an infusion therapy, and then oral rehydration.

With staphylococcal infections of the skin (furuncles, carbuncles, staphylodermia, etc.), the use of staphylococcal medicinal vaccine results in good results. The drug is administered subcutaneously in the shoulder region or in the subscapular region. The course of treatment consists of a single daily injection under a certain schedule for 9 days. In diseases with common skin lesions that occur with relapses, it is advisable to repeat the course of treatment after 10-15 days.

[1], [2], [3], [4], [5], [6]