Ortho Preferred Malpractice Insurance
Home » Bones » Cranio Facial » Staph aureus

Staph aureus

  - Discussion:
    - is a coagulase positive, gram positive organism (as opposed to coag neg s. epidermidis)
    - has a strong propensity to invade traumatized tissue;
    - often responsible for toxic shock syndrome and necrotizing fascitis;
           - serious infection that spreads rapidly along fascial planes and is commonly caused by staph or strep pyogenes;
           - anaerobes - especially clostridia and bacteroides can also be the cause; 
    - MRSA
    - staph aureus osteomyelitis is unique in that there is an ability to survive and hide withing osteocytes;
           - references: 
                    - Intracellular Staphylococcus aureus. A mechanism for the indolence of osteomyelitis.
                    - In vivo internalization of Staphylococcus aureus by embryonic chick osteoblasts. 
                    - Internalization of Bacteria by Osteoblasts in a Patient with Recurrent, Long-Term Osteomyelitis. 
                    - Osteomyelitis and Intraosteoblastic. Staphylococcus aureus
    - biofilm formation
    - progressive bacterial synergistic infections:
           - may begin as a small lesion that rapidly developes into synergistic gangrene, necessitating amputation;
           - peptostreptococcus and staphylococcus, the 2 organisms most often involved in this disease;
           - organisms act synergistically to produce necrosis and ulceration of both skin and subcutaneous tissues; 

- Treatment:
   - local antibiotic infusion into joints
   - antibiotic choices:
           - first generation cephalsporins (cefazolin);
           - penicillinase resistant penecillins
           - second line agents:
                  - vancomycin
                  - erythromycin
                  - clindamycin
                  - IMP 

 Methicillin Resistant Staph Aureus

Staph’s Trail Points to Human Susceptibilities

How Staphylococcus aureus Adapts to Its Host

Year Book: Antibiotic Resistance of Biomaterial-Adherent Coagulase-Negative and Coagulase-Positive Staphylococci

Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis

The efficacy of calcium mupirocin in the eradication of nasal Staphylococcus aureus carriage

Alteration of staphylococcal flora in cardiac surgery patients receiving antibiotic prophylaxis

Impetigo contagiosa III. Comparative efficacy of oral erythromycin and topical mupirocin

Alternatives to Vancomycin for the treatment of methicillin-resistant Staphylococcus aureus infections.

Antimicrobial Options in the Treatment of Adult Staphylococcal Bone and Joint Infections in an Era of Drug Shortages