Staphylococcal infection in children

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

ICD-10 code

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

Epidemiology of staphylococcal infection

The source of infection is patients and carriers of pathogenic strains of staphylococcus. The most dangerous are patients with open purulent foci (suppurating wounds, opened boils, purulent conjunctivitis, tonsillitis), as well as patients with intestinal disorders and pneumonia. After recovery, the "power" of the microbial focus quickly decreases and its complete sanitation may occur, but very often a long-term carriage without chronic foci of infection or with such foci is formed.

The infection spreads by contact, food and airborne droplets. In newborns and children in the first months of life, the contact route of infection transmission predominates. In these cases, infection occurs through the hands of medical personnel, the mother's hands, linen, and care items. Children in the first year of life are often infected by the alimentary route through the milk of a mother with mastitis or cracked nipples or through infected milk formulas. In older children, infection occurs when eating contaminated food (cakes, sour cream, butter, etc.).

Classification of staph infection

A distinction is made between 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 a subclinical form, in which there are no visible inflammatory foci at all, only a slight subfebrile temperature and blood changes are noted. In infants, this may cause poor appetite and poor weight gain. Staphylococcus can be isolated from blood culture.

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

There may be latent and asymptomatic forms that are not actually diagnosed, but they can be dangerous both for the patient and for those around them as a source of infection. The addition of any disease, most often ARVI, in these cases is accompanied by an exacerbation of staphylococcal infection and the occurrence of sometimes severe complications.

The most common localization of staphylococcal infection is the skin and subcutaneous tissue (staphyloderma). With cutaneous staphylococcal infection, an inflammatory focus with a tendency to suppuration and a reaction of regional lymph nodes such as lymphadenitis and lymphangitis develops quickly. In older children, staphylococcal skin lesions usually have the form of folliculitis, pyoderma, furuncles, carbuncles, hidradenitis. In newborns, vesiculopustulosis, neonatal pemphigus, and Ritter's exfoliative dermatitis are diagnosed. When the mucous membranes are affected, a clinical picture of purulent conjunctivitis and tonsillitis occurs.

Causes of Staph Infection

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

The genus Staphylococcus includes three species: golden (S. aureus), epidermal (S. epidermidis) and saprophytic (S. saprophyticus). Each species of staphylococcus is divided into independent biological and ecological types.

Pathogenesis of staphylococcal infection

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

With reduced resistance of the body to pathogenic staphylococcus, under the influence of the damaging effect of its toxins and enzymes, the pathogen and its toxins penetrate from the site of infection into the blood. Bacteremia occurs, intoxication develops. With generalized staphylococcal infection, various organs and tissues (skin, lungs, gastrointestinal tract, skeletal system, etc.) can be affected. As a result of generalization, septicemia, septicopyemia may develop, especially in newborns and children in the first months of life.

Causes and pathogenesis of staphylococcal infection

Symptoms of a staph infection

Staphylococcal laryngitis and laryngotracheitis usually develop in children aged 1 to 3 years against the background of acute respiratory viral diseases.

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

Staphylococcal laryngotracheitis is often accompanied by obstructive bronchitis and often pneumonia. The clinical course of staphylococcal laryngotracheitis is practically no different from laryngotracheitis caused by other bacterial flora. There are significant differences only with diphtheria croup, which is characterized by slow development, gradual change of phases, parallel increase in symptoms (hoarseness and aphonia, dry, rough cough and gradual increase in stenosis).

Symptoms of a staph infection

Diagnosis of staph infection

Staphylococcal infection is diagnosed based on the detection of purulent foci of inflammation. Of decisive importance is the detection of pathogenic staphylococcus in the lesion and especially in the blood. For serological diagnostics, RA with an autostrain and a museum strain of staphylococcus is used. An increase in the antibody titer in the dynamics of the disease undoubtedly indicates its staphylococcal nature.

Treatment of staph infection

In 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 anti-staphylococcal immunoglobulin, anti-staphylococcal plasma, staphylococcal anatoxin, staphylococcal bacteriophage, therapeutic staphylococcal vaccine). According to indications, surgical treatment methods, non-specific detoxifying therapy, and vitamin therapy are used. To prevent and treat dysbacteriosis, bacterial drugs (Acipol, Bifistim, Bifidumbacterin, Bificol Dry, etc.) are used, as well as stimulating therapy that increases the body's defense mechanisms (Taktivin).

Diagnosis and treatment of staph infection

Prevention of staph infection

The basis for preventing staphylococcal infection is strict adherence to sanitary and anti-epidemic measures (disinfection of household items, proper cleaning of premises, etc.), timely identification and isolation of patients - sources of infection. All preventive and anti-epidemic measures should be carried out especially carefully in maternity institutions (use of disposable linen sets, wearing masks by staff, etc.). In addition to identifying and isolating patients (mother or child), it is necessary to identify carriers of pathogenic polyresistant strains of staphylococci among care personnel and remove carriers from work, monitor staff compliance with sanitary and hygienic rules for caring for a child, storing nutritional mixtures, aseptic maintenance of individual nipples, dishes and other care items. At least 2 times a year, maternity hospitals are closed for disinfection and cosmetic repairs.

Prevention of staph infection

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