Staphylococcal infection in children

Staphylococcal infection is a large group of purulent-inflammatory skin diseases (pyoderma), mucous membranes (rhinitis, tonsillitis, conjunctivitis, stomatitis), internal organs (pneumonia, gastroenteritis, enterocolitis, osteomyelitis, etc.), CNS (purulent meningitis).

ICD-10 code

• A05.0 Staphylococcal food poisoning.
• A41.0 Septicemia caused by Staphylococcus aureus.
• A41.1 Septicemia caused by other specified staphylococci.
• A41.2 Septicemia caused by unspecified staphylococci.
• A49.0 Staphylococcal infection, unspecified.

Epidemiology of staphylococcal infection

The source of infection are patients and carriers of pathogenic strains of staphylococcus. The most dangerous patients with open purulent foci (festering wounds, cracked furuncles, purulent conjunctivitis, sore throat), as well as patients with intestinal disorders and inflammation of the lungs. After recovery, the "power" of the microbial focus rapidly decreases and its complete sanation may occur, but very often a prolonged carrier is formed without chronic foci of infection or with such foci.

The infection spreads through contact, food and airborne droplets. The newborn and children of the first months of life have a contact path of transmission of infection. Infection in these cases occurs through the hands of medical personnel, mother's hands, underwear, care items. Children of the first year of life are often infected and alimentary through the milk of a mother with mastitis or cracked nipples or through infected milk mixtures. In older children, infection occurs with the use of infected foods (cakes, sour cream, butter, etc.).

Classification of staphylococcal infection

Distinguish generalized (septicemia and septicopyemia) and localized forms.

In most cases, staphylococcal infection occurs in localized mild forms (rhinitis, nasopharyngitis, pyoderma) with slightly pronounced inflammatory changes, without intoxication or in the form of subclinical form, in which there are no visible inflammatory foci, note only a small subfebrile condition and changes in blood. Infants may have poor appetite and poor weight gain. When sowing blood, staphylococcus can be isolated .

Localized forms, however, are not always an easy disease: in some cases they are accompanied by very severe clinical symptoms with severe intoxication and bacteremia; therefore it is necessary to differentiate them with sepsis.

There are possible erased and asymptomatic forms that are not actually diagnosed, but they can be dangerous both for the patient himself and for others as a source of infection. Accession of any disease, more often SARS, in these cases is accompanied by exacerbation of staphylococcal infection and the occurrence of sometimes severe complications.

The most frequent localization of staphylococcal infection is skin and subcutaneous tissue (staphyloderma). With cutaneous staphylococcal infection, an inflammatory focus rapidly develops with an inclination to suppuration and regional lymph node reaction according to the type of lymphadenitis and lymphangitis. In older children, staphylococcal skin lesions usually have the form of folliculitis, pyoderma, furuncles, carbuncle, hydradenitis. Newborns are diagnosed with vesiculopustule. Pemphigus of newborns, exfoliative dermatitis of Ritter. With the defeat of the mucous membranes there is a clinical picture of purulent conjunctivitis, angina.

Causes of Staphylococcal Infection

Staphylococci are gram-positive microorganisms of spherical form, usually located in the form of clusters.

The genus Staphylococcus includes three species: golden (S. Aureus), epidermal (S. Epidermidis) and saprophytic (S. Saprophyticus). Each type of staphylococcus is divided into independent biologo-ecological types.

The pathogenesis of staphylococcal infection

The entrance gates are skin, mucous membranes of the oral cavity, respiratory tract and gastrointestinal tract, eyelid conjunctiva, umbilical wound, etc. At the site of introduction, staphylococcus causes local inflammation with necrosis and suppuration.

With a reduced resistance of the organism to pathogenic staphylococcus under the influence of the damaging effect of its toxins and enzymes, the pathogen and its toxins penetrate from the focus of infection into the blood. There comes bacteremia, intoxication develops. In generalized staphylococcal infection, various organs and tissues can be affected (skin, lungs, digestive tract, bone system, etc.). As a result of generalization, the development of septicemia, septicopyemia, especially in newborns and children of the first months of life.

Causes and pathogenesis of staphylococcal infection

Symptoms of Staphylococcal Infection

Staphylococcal laryngitis and laryngotracheitis develop, as a rule, in children aged 1 to 3 years, on the background of acute respiratory viral diseases.

The development of the disease is acute, with a high body temperature and a rapid appearance of laryngeal stenosis. Morphologically, a necrotic or ulcerative necrotic process in the larynx and trachea is noted.

Staphylococcal laryngotracheitis is often accompanied by obstructive bronchitis and often pneumonia. The clinical course of staphylococcal laryngo- tracheitis is virtually identical to laryngotracheitis caused by another bacterial flora. Significant differences are only with diphtheria croup, which is characterized by slow development, gradual phase change, parallel increase in symptoms (hoarseness and aphonia, dry, rough cough and gradual increase of stenosis).

Symptoms 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.

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).

Diagnosis and treatment of staphylococcal infection

Prevention of staphylococcal infection

The basis of the prevention of staphylococcal infection - the steady compliance with the sanitary anti-epidemic regime (disinfection of household items, proper cleaning of premises, etc.), timely detection and isolation of patients - sources of infection. Especially carefully all preventive and antiepidemic measures should be carried out in obstetrical institutions (use of sets of single linen, wearing masks, etc.). In addition to identifying and isolating the sick (mother or child), it is necessary to identify carriers of pathogenic polyresistant strains of staphylococcus among caregivers and remove carriers from work, monitor staff compliance with the hygiene rules for the care of the child, store nutritional mixtures, aseptic content of individual nipples, dishes and other items of care. At least 2 times a year, maternity hospitals are closed for disinfection and cosmetic repairs.

Prevention of staphylococcal infection

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