Staphylococcus Aureus
What is 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
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
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.
Name | Dosage | |
Fusidic acid | 500 mgs - 1 g | 2-3 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 ml | 2-3 times a day for 10-14 days |
Mupirocin | Intranasally. | Apply to the affected area up to 3 times a day for 10 days. |
Levofloxacin | 250 - 750 mgs | once a day |
Moxifloxacin | 400 mgs | once a day intravenously |
Linezolid | 400 - 600 mgs | twice a day for 10-14 days ( enterococcal infections - 600 mgs for 14 - 28 days) |
Norfloxacin | 400 mgs | twice a day for 7-14 days |
Grepafloxacin | 400 - 600 mgs | once a day for 7 - 10 days |
Roxithromycin | 300 mgs | once or twice a day |
Ciprofloxacin | 500 mgs | twice a day for 7 - 14 days |
Cefepime | 500 mgs - 1 g | twice a day for 7 - 10 days |
Doxycycline | 200 mgs at first day, 100 mgs at other days | 5 - 10 days |
Vancomycin | 500 mgs - 1 g | 500 mgs every 6 hours, 1g every 12 hours |
Tobramycin | 1 mgs/kg | 1-3 times a day for 5 - 10 days |
Cefazolin | Intramuscular, intravenous. 1-4 g / day (max - 6 gramm a day) | 2-3 times a day for 7-10 days |
Cefotaxime | 1 - 2 g | every 8 - 12 hours |
Fosfomycin | 3 g at 2 hour before a meal at night | 1 - 2 times |
Lomefloxacin | 400 mgs (up to 600-800 mgs) | twice a day for 10 - 14 days |
Clindamycin | 150-450 mgs | 3-4 times a day for 10-14 days |
Rifampicin | 450 - 900 mgs | once a day at 1 hour before a meal for 7 - 10 days |
Ceftriaxone | 1 - 2 g once a day | not 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. |
Nitroxoline | 100 mgs (max daily dose - 800 mgs) | 4 times a day during a meal for 2-3 weeks. |
Piperacillin | Intramuscular, intravenous. 2 - 4 g every 6-12 hours | 7 - 10 days |
Ceftazidime | 1 - g | every 8 hours at least 5 days |
Cefoperazone | 2 - 4 g (max 8 g) | at least 10 days |
Azithromycin | 250 - 500 mgs | once a day at least 1 hour before or 2 hours following a meal |
Cefamandole | Intramuscular, intravenous. 0,5-1 g (max daily dose - 12 g) | 3-6 times a day for 10-14 days. |
Cefpodoxime | 100 - 200 mgs | twice a day for 10-14 days. |
Mafenide | 1,5-2 mm layer of ointment or cream | 1 - 5 weeks |
Meropenem | 500 mgs - 1 g | every 8 hours |
Oxolinic acid | 500 mgs - 1 g | 4 times a day for at least 7 days. |
Nifuratel | 600 mgs - 1,2 g | 2-3 times a day for 7-14 days |
Pipemidic acid | 400 mgs | 2-3 times a day (at morning and night) for 10 days and more |
Ceftizoxime | Intramuscular, intravenous. 1-2 g | every 8 - 12 hours |
Erythromycin | 250 - 500 mgs | 4 times a day at least 2 hours before a meal |
Cefuroxime | Intramuscular, intravenous. 750-1500 mgs | 3-4 times a day for 5 - 10 days and more |
Tryiodinerezorcine | Apply a thin layer to affected skin | 1-3 times a day for 1-4 weeks |
Streptomycin | Intramuscular. 15 mgs / kg /day (max 2 gramm a day) | for 7-10 (no more than 14) days. |
Benzalkonium chloride | Apply at the rate of 0.2-0.4 g/cm2 wound surface (max 50 gramm a day) | for 14 days. |
Picloxydine | Conjunctival, 1 drop in affected eye | 2-6 times a day for no more than 10 days. |
Fenticonazole | Vaginally. 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 green | Externally applied to the affected area, covering the surrounding healthy tissue | |
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