Treatment of Staphylococcus aureus in children. Staphylococcus aureus in a newborn child: signs and treatment of infection in the intestines, on the skin and mucous membranes

Ekaterina Morozova - mother of many children, editor of the "Children" column in Colady magazine

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Staphylococcus aureus is a bacterium that, unlike many prokaryotes, has a golden color, which is the causative agent of purulent pathological processes in the human body.

Children are most susceptible to infection with Staphylococcus aureus, so today we will talk about the causes of diseases resulting from infection, symptoms and effects of Staphylococcus aureus for kids.

Causes of the disease, how is it transmitted?

• Staphylococcus aureus is transmitted as by airborne droplets, and through food(contaminated meat, eggs, dairy products, pastries, cream cakes) or household items.
• Staphylococcus aureus can also enter the child's body through microtrauma of the skin or mucous membranes respiratory tract.

In most cases, infection with Staphylococcus aureus occurs in medical institutions.

Imbalance of intestinal microflora, weakened immune system, autoinfections - the main causes of infection with Staphylococcus aureus. The highest risk of infection are premature babies and immunocompromised babies .

During childbirth , through wounds or scratches, and through breast milk the mother can infect the child. If the bacteria entered the mother's body through cracks in the nipples, then this can lead to purulent mastitis in her.

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Staphylococcus aureus in children, if not treated in time, can cause diseases such as osteomyelitis, meningitis, pneumonia, infectious-toxic shock, sepsis, endocarditis and etc.

Degrees in children - what is the carriage of Staphylococcus aureus?

There are two stages of infection with Staphylococcus aureus in children.

• At an early stage, when several hours have passed since the infection, the disease is characterized by lethargy, diarrhea, high fever, vomiting, lack of appetite.
• late form The disease does not appear immediately, but after 3-5 days. In this case, the symptoms of Staphylococcus aureus in children are skin lesions (boils, purulent wounds), infection of internal organs and blood.

Often visible manifestations of the disease are interpreted in various forms. They may appear as spot rash or sores, solitary pustules or evenly cover the skin. Therefore, such symptoms are often confused with diaper dermatitis and do not attach importance to infection.

Sometimes the disease is asymptomatic and can only be detected through laboratory tests. In this case, the causative agent of infectious diseases remains in the child's body and is periodically released into the environment. This type of disease is called carriage of Staphylococcus aureus , and this carriage is not treated with any antibiotics.

If there are no visible symptoms of Staphylococcus aureus, and the child does not show concern, then medical treatment is postponed, and parents are closely involved strengthening the child's immunity.

The situation is much more serious with the active manifestation of the disease. At the slightest suspicion of illness, you need to urgently go to the hospital. The mother and child are hospitalized, which is accompanied by drug treatment.

Only with strict adherence to all prescriptions of doctors you can get rid of the infection and avoid recurrence of the disease!

Signs and symptoms. How is the analysis performed?

There are many signs of the manifestation of Staphylococcus aureus in newborns and preschool children. These are:

• Ritter's disease (Scalded Skin Syndrome). In this case, a rash or an area of ​​inflamed skin with clear boundaries appears on the skin.
• Staphylococcal pneumonia. Pneumonia caused by staphylococcal infection is much more severe than in other cases. There is severe shortness of breath, pronounced intoxication, there is pain in the chest.
• Phlegmon and abscesses. Deep lesions of the subcutaneous tissue, followed by purulent fusion. With an abscess, the inflammation is in the form of a capsule, which prevents the process from spreading further. Phlegmon is a more serious form, because. purulent inflammatory process further expands through the tissues.
• pyoderma- damage to the skin in the area of ​​\u200b\u200bthe exit of hair to the surface of the skin. The appearance of an abscess in the area of ​​\u200b\u200bhair growth, when an abscess forms around a hair (folliculitis), indicates a superficial lesion. With more serious skin lesions, not only inflammation of the hair follicle develops, but also the surrounding tissues (furuncle), as well as inflammation of a whole group of hair follicles (carbuncle).
• Brain abscess or purulent meningitis can develop due to the appearance of carbuncles and boils on the face, because the blood circulation on the face is specific and staphylococcus aureus can enter the brain.
• Osteomyelitis. In 95% of cases, purulent inflammation of the bone marrow occurs due to a staphylococcal infection.
• Sepsis- when a huge number of staphylococcal bacteria are carried by blood throughout the body, where secondary foci of infection subsequently occur, manifested in the internal organs.
• Endocarditis- heart disease, in 60% of cases ending in death. It occurs as a result of damage to the inner lining and valves of the heart by staphylococcus aureus.
• Toxic shock. A large number of aggressive toxins that have entered the bloodstream cause fever, an instant drop in blood pressure, headache, vomiting, abdominal pain, and impaired consciousness. With food toxicosis, the disease manifests itself 2-6 hours after eating.

To identify the causative agent of the disease, you need to pass analysis of blood and / or biological fluid from wounds for Staphylococcus aureus. After conducting research in laboratories and testing for susceptibility to antibiotics, the doctor prescribes antibiotics that can kill staphylococci.

What are the consequences and why is it dangerous?

Staphylococcal infection can affect any organ. The consequences of Staphylococcus aureus are unpredictable, because. it is this type of staphylococcus that can cause diseases that in the future, if not treated on time, can become chronic.

Statistically, already on the third day, 99% of newborn babies have a staphylococcus bacterium, both inside the baby's body and on the surface of the skin. With strong immunity, this bacterium peacefully coexists with the rest of the bacteria in the body.

• Most often staphylococcus affects the nasopharynx, brain, skin, intestines, lungs.
• Staphylococcus aureus is dangerous because untimely treatment of an advanced disease can lead to death.
• With food poisoning and superficial manifestations on the skin, you need to sound the alarm and contact qualified specialists, and not wait until a staphylococcal infection affects the internal organs and will become septic, i.e. - blood poisoning.

To protect a newborn as much as possible from infection with Staphylococcus aureus:

• Support the child's immunity;
• Observe the rules of personal hygiene;
• Keep bottles, nipples, spoons, other feeding utensils, toys and household items clean.

Site site warns: self-medication can harm the health of your baby! The diagnosis should be made only by a doctor after the examination. Therefore, if you find symptoms of Staphylococcus aureus in a child, be sure to consult a specialist!

Staphylococcus aureus in children is an insidious bacterium that contributes to the occurrence of dangerous complications of a purulent-inflammatory nature. An ailment appears, both in adults and children, starting from the first day of birth. A fragile children's body is most susceptible to a staphylococcal microbe. Infection occurs for a number of reasons, including due to non-compliance with the rules of personal hygiene (washing hands), as well as when the immune system is weakened.

A pathogenic microorganism penetrates the body of the crumbs, affects the internal organs and tissues. Even an experienced specialist can hardly recognize the culprit of the disease.

Why is staphylococcus dangerous?

Pathogenic flora weakens the protective functions of the child's body. Becoming active, it can cause serious diseases in a child, which are treated with great difficulty.

Causes of Staphylococcus aureus bacteria in a child:

1. Maternal infections during pregnancy.
2. Unbalanced nutrition and stress during gestation.
3. Taking medications (antibiotics, hormones) during pregnancy.
4. Birth before term. Premature babies who are late attached to the breast are at risk of getting this disease.

All of the above cases can provoke allergies, serious disorders in the intestines, and also contribute to the appearance of staphylococcus aureus.

When passing a fecal analysis for staphylococcus a value of 103 is considered normal. Many parents mistakenly believe that there should be no staphylococcus in the test forms at all. The bacterium can be in the human body within the normal range and at low rates does not cause him any danger.

Doctors refer to Staphylococcus aureus in children as a provocateur of many dangerous diseases, such as meningitis, inflammation of the lungs and intestines. However, cases are quite rare, and appear in very debilitated young patients.

Timely access to specialists will minimize the appearance of dangerous diseases.

Signs and symptoms of Staphylococcus aureus in children

At the initial stage of the disease, symptoms appear already on the first day after infection. This form is characterized by:

• bowel disorder (loose stools);
• reflex eruption of stomach contents (vomiting);
• loss of appetite (refusal to eat);
• lack of vigor, mobility.

In the late form, the insidious infection causes a number of complications:

• lesions of the skin and subcutaneous tissue (Ritter's disease, pyoderma, phlegmon, abscesses);
• blood poisoning (sepsis);
• purulent inflammation of the bone marrow;
• severe inflammation of the internal organs (staphylococcal pneumonia, brain abscess, endocarditis).

If a large number of toxins enter the bloodstream, the baby may experience prolonged fever, abdominal pain, loss of consciousness, convulsions and vomiting. If toxicosis was caused by food, then the disease will manifest itself already in the second third hour after feeding.

In some cases, Staphylococcus aureus in children does not manifest itself in any way, the disease may not bother the baby for a long time.

Tests for staphylococcus aureus

To identify a staphylococcal infection, it is necessary to pass a series of tests. Already in the maternity hospital, a stool sample is taken from a newborn to confirm or refute the diagnosis.

Staphylococcus microorganisms are found in different bacteriological cultures:

• in feces;
• staphylococcus in the throat of a child and in the nose;
• in blood.

If Staphylococcus aureus is detected in the feces, children have all the symptoms of a gastrointestinal disorder (diarrhea, vomiting). The analysis reveals pathogenic microflora. With frequent complications and suspicions of bronchitis, inflammation of the lungs, it is necessary to take bakposev from the pharynx and nose. Staphylococcus aureus in the throat is detected after a smear from the throat. Positive titers in the analysis form near the Staphylococcus aureus column will indicate the culprit of the disease. Staphylococcus aureus in the blood is a threat of death.

After passing the tests, the doctor will draw the appropriate conclusions and prescribe medication to the child.

Treatment of Staphylococcus aureus

The microorganism is sufficiently resistant to external influences. If many bacteria can be cured with hydrogen peroxide alone, then it is much more difficult to get rid of Staphylococcus aureus in a child. Experts believe that Zelenka and chlorophyllipt solution will help to cope with the disease. However, the tactics of treatment in each case is different. The doctor looks at the behavior and well-being of a small patient. If a pathogenic bacterium is found in the feces of a child, but there are no manifestations, drug therapy is not prescribed.

Basically, the treatment of Staphylococcus aureus in children is carried out by pharmaceutical means:

• complexes of vitamins and minerals;
• bacteriophages;
• antibacterial agents;
• antiseptic compresses.

The microbe is quite immune to broad-spectrum antibiotics of the penicillin group. Staphylococcus aureus is resistant even to boiling, withstands a high temperature range up to 150 ° C.

Folk methods in the fight against pathogenic bacteria have proven themselves on the positive side. Medicinal herbs have properties that can resist the microbe. A decoction of chamomile and St. John's wort is used as an anti-inflammatory and antiseptic agent in the treatment of conjunctivitis. Effectively gargling with calendula for sore throat caused by staphylococcus aureus. For rashes, damage to the skin, decoctions from the series can be used. Rosehip decoction helps to raise immunity and strengthens the protective functions of a fragile child's body. St. John's wort improves digestion, relieves inflammation in the intestines and destroys pathogenic flora.

How to protect a child from a staph infection?

To reduce the risk of the appearance of a newborn Staphylococcus aureus in the body, it is important to eliminate factors aimed at reducing the protective functions of the body. It is important to properly store food, you can not eat expired food and without special heat treatment. Breastfeeding women need to be careful not to pass the infection into breast milk. If the child is bottle-fed, bottles and nipples must be carefully sterilized.

Awareness about the ways of infection is the best preventive measure. The way of transmission of Staphylococcus aureus is airborne and contact. Sources of infection with a bacterium in a medical setting:

• improperly processed medical devices and instruments;
• parenteral nutrition;
• hemodialysis, etc.

The risk group is premature babies, as well as patients with immunodeficiency. The staphylococcal pathogen develops after illnesses that have led to a decrease in the protective properties of the body. Long-term antibiotic therapy and surgery can also lower immunity.

About 1/3 of the world's population has Staphylococcus aureus bacteria on their skin.

If all preventive measures were followed, but the child fell ill with Staphylococcus aureus, you should not waste time, do not self-medicate, but make an appointment with a doctor as soon as possible and start treating. The specialist will help to establish an accurate diagnosis, prescribe the optimal treatment. By following all the recommendations of the doctor, you can permanently get rid of a dangerous disease. Only such a tactic will help remove all the lesions of staphylococcus aureus in the child's body.

With the improvement of the test results, we can assume that the treatment is chosen correctly. Medications must be taken in the order and for as many days as prescribed by the doctor. If the disease is not completely cured, it may recur again and then surgery is needed. Immunity to the staphylococcal microbe is not formed, which means that children can become infected again. Parents should carefully examine the body of the newborn and, if pustules or any other ailments appear, contact a specialist.

Hardening crumbs and gymnastics have a beneficial effect on immunity. It is important to walk for 2-3 hours daily with a newborn, arrange air baths for him and at the same time not wrap him up. Taking a warm bath with the addition of chamomile will prevent many diseases, including protecting the child from Staphylococcus aureus.

The habitat of Staphylococcus aureus is clothes, walls, house dust, etc. But the real danger threatens only with reduced immunity of the crumbs. That is why parents should follow a healthy lifestyle and instill it in their child from infancy.

Staphylococcus aureus most often affects young children with weakened immune systems or other associated infections. Often staphylococcus, and E. coli are found in babies with. Thus, it is violations of local immunity that are the main cause of staphylococcal infection.

It is noteworthy that staphylococci are extremely resistant to the action of many antibiotics, so there is always a risk that the child will become ill with a purulent-septic disease.

How can a child become infected with staphylococcus aureus? The carriers of this dangerous bacterium are both sick and healthy people, because there are different forms of carrying the infection (temporary and permanent). The course of the disease can also occur in mild and severe forms. Staphylococcus aureus causes sepsis, pneumonia, and purulent inflammation of the skin and other tissues. With the generalization of the inflammatory process in newborns, sepsis often develops.

The idea that the microorganism affects only the intestines is erroneous. The objects affected by staphylococcal infection are extremely variable: upper and lower respiratory tract, mucous membranes of the mouth, nose, intestines, skin, bone and cartilage tissue, etc.

The children's body is affected by staphylococci of three groups:

Epidermal staphylococcus aureus. Among the varieties of staphylococci, epidermal has an average infectious potential. It occurs on the skin and mucous membranes, but during the normal operation of the carrier's immunity, it does not manifest itself in any way. Signs of bacterial damage appear only if the carrier's immunity is weakened: after surgery, a viral disease, etc. Newborns, especially premature babies, are particularly susceptible to infection.

Saprophytic staphylococcus. Least hazardous to health. It almost never occurs in children, since the main "target" is the organs of the excretory system.

Staphylococcus aureus. The most dangerous and extremely virulent microorganism. In normal healthy children, Staphylococcus aureus is in a latent state. Of all the varieties of these microorganisms, the most aggressive.

Signs and symptoms of staph in children

In most cases (from 48% to 78%), it is staphylococcus bacteria that cause inflammatory diseases of the respiratory tract, which are common in children.

Staphylococcal pneumonia can occur after infection of a child in a hospital or maternity ward. The disease often develops at lightning speed, with destruction of lung tissue and other complications. Toxins produced by staphylococcus aureus cause severe intoxication of the body, which in combination with causes a violation of the respiratory system and blood circulation. A sick child is restless, tosses about in bed, may moan and scream. Chills, dryness and puffiness of the face are also characteristic symptoms.

Staphylococcal enterocolitis is an extremely severe intestinal disease. In 13% of cases, it ends in death. Premature and weak children are susceptible to the disease. It is also provoked by previously transferred acute respiratory diseases, taking antibiotics, artificial feeding and violations of the intestinal biocenosis.

The nature of the manifestations depends, first of all, on the type of microorganism:

Saprophytic staphylococcus. For saprophytic staphylococcus a lesion of the genitourinary system is characteristic.

1. Pain in the lower abdomen (in women);

General and local symptoms of staphylococcus in children

By systematizing the symptoms, it is possible to generalize all manifestations into two large groups: general and local.

Local manifestations:

Eruptions on the skin and mucous membranes. Boils ("abscesses"), etc. In children, they are especially often localized on the mucous membrane of the nose and throat. The development of spots, large boils speaks of the severe course of the process.

Purulent discharge in biological fluids. Mucus from the nose, sputum with impurities of pus indicate damage to the mucous membranes of the upper or lower respiratory tract.

General manifestations:

• The form is characterized by specific symptoms:

  Sore throat;

  Swelling and redness of the tonsils;

  Purulent rashes on the surface of the mucosa, as well as mucous membranes of the oral cavity (stomatitis);

  General manifestations of intoxication.

Staphylococcus on the intestinal mucosa provokes typical signs of the development of acute colitis (moreover, both the large and small intestines can be affected, that is, the disease will take the form of enterocolitis).

Symptoms include:

• Pain in the abdomen (wandering, arching);

  Discomfort in the epigastric region (heaviness, bloating, feeling of fullness);

  Impurities of pus, blood, green mucus in the feces;

  Taking antibiotics. Treatment with antibiotics for infectious pathologies (especially staphylococcal) should be careful. Staphylococcus has amazing adaptability. Illiterate antibacterial treatment will lead to the formation of a bacterium with great resistance and virulence. It is advisable to take only those drugs to which staphylococcus is sensitive (should be based on the results of bacteriological studies).

  Lubrication, rinsing. To combat bacteria on the mucous membranes of the nose and throat, lubrication and rinsing are used. Most often, a solution of silver, iodinol, hydrogen peroxide, as well as special preparations (Miramistin and others) are used.

  Reception of vitamin and mineral complexes. Used to replenish missing substances.

  Immunomodulators. They are used to restore the protective functions of the body.

  Transfusions. Significant damage to staphylococcus aureus can lead to serious complications, such as blood poisoning. In this case, blood or plasma transfusion is indispensable.

  Operational intervention. In severe chronic tonsillitis, the removal of the tonsils is indicated, and surgery is also resorted to when there are multiple skin lesions with profuse exudate and inflammation.

For the treatment of staphylococcus in children, vitamin C is always used, which stimulates the immune system and supports the weakened body of the baby. With external purulent lesions, it is recommended to make baths and frequent poultices. The child's skin should be as clean and dry as possible. It is also necessary to control the cleanliness of the nails and underwear of a sick child. Sores should be constantly treated, scabs and pus removed. Household items, utensils and clothing used by a sick child are also subject to processing and disinfection.

For the prevention of staphylococcal infection, it is necessary to observe sanitary standards and implement epidemic control. Pregnant women, women in labor and newborns must be screened. If purulent inflammatory diseases are detected, they are subject to hospitalization and treatment in departments with an infectious regimen.

Thus, staphylococcal infection poses a great danger to children (both newborns and older children). Especially dangerous and insidious is Staphylococcus aureus, which has a high virulence and toxic ability. Symptoms are extremely specific and manifest themselves in each child individually. In general, there is a picture of inflammation and purulent lesions of the skin and mucous membranes of the body (nose, throat, intestines).




Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. He also received a certificate of a specialist in 2014.

Medical statistics show that this bacterial infection is found in the intestinal microflora and on the nasal mucosa in 40% of children under the age of one year and newborns. Staphylococcus aureus is a frequent companion of the human microflora. The insidiousness of this microbe lies in the fact that, peacefully adjacent to a healthy person, it leads to serious illnesses in people with a weakened body, including infants and premature babies. In such children, staphylococcus aureus causes severe systemic lesions in 20-44% of cases.

Staphylococcus aureus: symptoms in children

The infection manifests itself in different ways, depending on which organs are most damaged. Most often, Staphylococcus aureus manifests itself in a localized form (lesions of the skin, urinary system, gastrointestinal tract, eyes). There are a lot of symptoms of infection - only about a hundred.

Staphylococcus aureus in infants: symptoms

Most often, Staphylococcus aureus is found in infants in the feces, on the mucous membranes and on the skin, causing the following symptoms and diseases:

1. Skin rashes, which can be either the result of extensive colonization of Staphylococcus aureus on the surface of the body, or the result of allergic manifestations. The bacterium produces 4 types of toxins and more enzymes, leading to increased sensitivity of the body. In 90% of children with atopic dermatitis, Staphylococcus aureus is detected on the skin. The nature of the rash can be different. Already on the 5-6th day after birth, small blisters with purulent contents may appear on the body of the baby, which eventually burst and leave crusts. The formation of purple-red suppurating boils is accompanied by a general deterioration in the child's condition and may indicate the imminent onset of blood sepsis. The nature of extensive inflammatory processes may resemble severe burns.
2. Indigestion: loose, frothy and frequent stools; a large amount of mucus, blood in the stool; regurgitation, profuse vomiting (1-2 times a day with a mild form of the disease or repeated with severe). Mucus and streaks of scarlet blood in the feces of a child indicate inflammation of the colon, the presence of erosion in the small intestine can be determined by passing an occult blood test. Infection of the intestines in weak infants can lead to necrotizing enterocolitis - ulceration and death of the intestinal wall, as well as peritonitis.
3. Non-healing, suppurating umbilical wound.
4. Angina, which is characterized by an increase in lymph nodes.
5. Purulent rhinitis. In infants, it proceeds in an acute form - with high fever, symptoms of intoxication, copious purulent discharge from the nose.
6. Often, in children under one year old, after suffering rhinitis, otitis media develops due to staphylococcal infection. With an unfavorable development of the disease, the bacterium can cause brain inflammation in the baby - meningitis (about 3% of all meningitis is associated with staphylococcus aureus).
7. Weakened infants after SARS may develop staphylococcal stomatitis, which is also very difficult for them to tolerate (high temperature, intoxication, complete refusal of food).
8. Staphylococcal pneumonia when infected by airborne droplets or when it enters the lungs through the blood.
9. Inflammation of bone tissue and joints with pain when moving.
10. 10. In severe cases of sepsis, the heart, liver, spleen are affected, the course of the disease is accompanied by several complications and can be fatal within 3-5 days.

Staphylococcus aureus symptoms in older children

In older children, the symptoms of a staph infection are slightly different, in part because the body is fighting back more effectively:

• Skin diseases are more often manifested in the form of acne, pustular rashes; folliculitis, furunculosis or carbuncles with inflammation of the hair roots and surrounding tissues. During puberty in children, staphylococcal colonies often affect the axillary region.
• Green mucous discharge from the nose without fever, which indicates the development of purulent rhinitis.
• Infection of the gastrointestinal tract resembles acute food poisoning: abdominal pain, profuse vomiting, weakness and dizziness, diarrhea with mucus and blood streaks. In severe cases, toxicosis can lead to death. With a mild form, complete recovery occurs in 1-3 days.
• In girls, the use of tampons during menstruation can lead to staphylococcal sepsis with toxic shock syndrome, accompanied by fever, diarrhea, vomiting, and skin rashes.

To accurately identify Staphylococcus aureus, it is necessary to take tests. Depending on the location of the infection, these may be swabs from the pharynx and nose; collection of pus and sputum; blood, urine and stool tests. Normally, Staphylococcus aureus in the feces of a child over the age of one year should not exceed the value of 10 to the fourth degree CFU per 1 gram of feces. For infants up to a year, this indicator is not standardized.

Ways of infection with Staphylococcus aureus

Infection with staphylococcus aureus in children can occur at almost any stage of their life - from perinatal to older age, under the influence of many factors:

• Infection of the mother before childbirth. Staphylococcus can cross the placental barrier during pregnancy or get to the baby during passage through the birth canal.
• Carrying the infection is widespread among employees of medical institutions, including maternity hospitals. So-called nosocomial infections are the scourge of modern medicine. According to sanitary rules, every maternity hospital must be closed twice a year for complete sanitization of infections and necessary repairs, but in practice these rules are not observed.
• Bacteria are transmitted either by contact - through dirty hands, or by air. Microbes from the air can get not only by direct contact with the patient, but also by shaking bed linen. Sharing household items, toys, also leads to microbes getting on the skin and mucous membranes. Staphylococcal bacteria remain viable on these objects and in dust for 2-3 weeks.
• Risk factors for infection are damage and diseases of the skin, mucous membranes; immunodeficiency; metabolic disorders (including diabetes); prematurity of newborns; general weakness of the body; surgical interventions. During breastfeeding, Staphylococcus aureus can penetrate through cracks in the nipple, especially if a woman has mastitis.
• Staphylococcal bacteria can often be contracted by eating improperly processed or stale meat and dairy products and salads. The complete destruction of bacteria in food products is possible only at a temperature of 100 degrees.
• Family carrier of the infection. In 60% of cases in children with staphylococcal lesions of the gastrointestinal tract, one of the parents also suffers from this infection, or is its carrier.

Newborns just discharged from the hospital can be passive carriers of staphylococcus for several months until the bacterium finds a reason to express itself. According to some estimates, staphylococci are found on the nasal mucosa in 52%, and in the intestines in 40-46% of children older than a year. By the second or third year, these figures decrease to 9-14%, and by the age of 4-6 they increase again and approach the indicators of carriage in adults - 30-50%.

Treatment of Staphylococcus aureus in children

For older children with a mild course of the disease, symptomatic or local therapy is usually used, outpatient treatment is possible.

The moderate form of the disease requires an integrated approach - the use of antibiotics (cefobid, amoxiclav, lendacin, cefamezin, amoxicillin and other drugs that are administered intramuscularly or intravenously), staphylococcal bacteriophage, detoxification agents (glucose-salt droppers), protein preparations (albumin, plasma), antihistamines (diphenhydramine, suprastin, fenkarol), probiotics and prebiotics.

In a severe form of the disease in infants, special preparations are additionally used - anti-staphylococcal immunoglobulin, anti-staphylococcal plasma, staphylococcal toxoid. With timely antibiotic therapy, it is possible to avoid severe complications and significantly reduce mortality.

Children who have had a staphylococcal infection should be registered at the dispensary at the local clinic for a year.

Since the prevalence of staphylococcal infection is very high, re-infection with it is not excluded, especially if the child is exposed to the above risk factors. The immunity developed in the body after the disease persists for a very short time, and there is no innate immunity to staphylococcus at all.

Fortunately, the mere carriage of staphylococcal bacteria on the skin and mucous membranes does not mean that pathogenic infection can occur with the development of complications. In a healthy human body, this bacterium coexists peacefully, without causing damage. Therefore, the main prevention of staphylococcal infection is hygiene, general strengthening measures to maintain immunity and a healthy diet.

What is staphylococcal infection in children -

staph infection- a large group of purulent-inflammatory diseases of the skin, internal organs, mucous membranes, central nervous system, caused by pathogenic strains of staphylococci.

According to the international classification, staphylococcal infection is of the following types:

Staphylococcal food poisoning;

Septicemia due to Staphylococcus aureus;

Septicemia caused by other specified staphylococci;

Septicemia due to unspecified staphylococci;

Staphylococcal infection, unspecified.

The infection is spread among the population by patients and carriers of pathogenic strains of staphylococcus aureus. The highest chance of infection is from patients with open purulent foci (such as open boils, tonsillitis, purulent conjunctivitis, festering wounds), with pneumonia and with intestinal disorders. In these cases, the infection spreads in the environment, where it poses a danger to adults and children.

At the peak of the disease, children excrete the maximum mass into the external environment. The mass decreases significantly after recovery, but in frequent cases the child becomes a carrier after the symptoms disappear, continuing to infect others. Healthy carriers also pose a great threat, especially if they work in the medical field, in maternity hospitals, neonatal wards, premature babies, or in food units.

Staphylococcal infection is transmitted in the following ways: contact, food, airborne. Most newly born and infants who become ill are infected through contact. This can happen through the hands of the mother or medical staff, through care items or underwear. Children under 12 months often become infected through the alimentary route - the infection enters the body through milk if the mother has mastitis or cracked nipples. Staphylococcus-infected formulas for feeding are also dangerous.

Children of preschool and school age often become infected by eating contaminated foods such as sour cream, other dairy products, cakes, etc. When staphylococcus is ingested, it multiplies in a beneficial environment, excreting. Airborne droplets can become infected if the child is close to a sick or carrier. Staphylococcus in this case colonizes the nasal cavity and oropharynx.

At risk are newborns and infants. The reasons for their high susceptibility to staphylococcus aureus are weak local antibacterial immunity of the respiratory tract and gastrointestinal tract. As you know, newborns do not secrete secretory, which plays an important role in the local defense of the body. The saliva of infants has a very weak bactericidal effect, mucous membranes and skin are vulnerable. This is also the reason for the high susceptibility of infants to staphylococcal infections.

Susceptibility is promoted by weakening by any diseases, exudative diathesis, malnutrition, artificial feeding of the baby, long-term use of antibiotics and corticosteroid hormones.

The actual number of cases is not known, since localized forms, unlike severe ones, are usually not recorded (eg, infected wounds, pyoderma).

Staphylococcal diseases are sporadic, but there are group diseases, family diseases, as well as epidemics in maternity hospitals, neonatal wards, etc. Outbreaks can also occur due to the consumption of contaminated food by children at schools, summer camps and other similar organizations. Acute gastrointestinal diseases caused by staphylococci are characteristic of the warm season, but can also occur in the cold months.

What provokes / Causes of Staphylococcal infection in children:

Staphylococci- gram-positive microorganisms having the shape of a ball. Genus Staphylococcus is divided into 3 types: epidermal, golden and saprophytic. Staphylococcus aureus is subdivided into 6 biovars. For humans, pathogenic type A, it excites most diseases of a staphylococcal nature, the rest of the biovars affect birds and animals.

Due to the toxic and allergic processes described above, immunity is sharply reduced, the permeability of membranes and vessel walls increases, which contributes to the septic process. Symptomatically, this is manifested by metastasis of purulent foci and the formation of sepsis.

The course of food poisoning depends on how much pathogen and enterotoxin has entered the child's body. staphylococcus aureus is found in large quantities in such biological material taken from the patient as vomit and feces, as well as in the remains of the food that caused the infection. But with food poisoning, the pathological process depends mostly on the enterotoxin that came with food.

Pathomorphology. At the site of entry of staphylococcus into the body, a local focus of inflammation appears, which in structure consists of staphylococci, serous-hemorrhagic exudate, necrotically altered tissues, which are surrounded by leukocyte infiltration. Further, microabscesses are formed, which can merge, forming foci.

If the infection has got on damaged skin, the formation of boils, carbuncles begins. If the entrance gate is the mucous membrane of the child's oropharynx, angina, stomatitis, etc. begin. Primary changes can be observed in the lungs - serous-fibrinous exudate and leukocyte infiltration appear there. But in frequent cases, small, sometimes merging foci of abscessing pneumonia are formed, and rarely - large foci that are located subpleurally.

Staphylococcal diseases of the gastrointestinal tract are characterized by ulcerative, catarrhal or necrotic lesions. Morphological changes occur in the small intestine, although the pathological process can also affect the large intestine. Epithelial tissues become necrotic, and sometimes necrosis also affects the deeper layers of the mucous membrane. There is infiltration of the mucosa and submucosa with severe circulatory disorders. Ulcers form.

When (and if) the infection is generalized, sepsis occurs, then staphylococcus through the blood reaches various organs and systems, for example, bones, central nervous system, liver, etc. Metastatic foci of inflammation appear there. Morphologically, abscesses are determined in various organs.

Symptoms of staphylococcal infection in children:

A staph infection can present with many symptoms. It depends on the site of infection in the body and on the severity of the primary inflammatory focus. Staphylococcal infection in children can be generalized or localized in form.

Most cases are localized mild forms, such as nasopharyngin or rhinitis. Minor inflammatory changes are observed, there is no intoxication. In infants, these forms may be manifested by poor appetite and insufficient weight gain. Blood culture allows you to isolate staphylococcus aureus.

But localized forms do not always go away easily, they can be accompanied by severe symptoms, severe intoxication and bacteremia, so they may need to be differentiated from sepsis.

The disease can proceed in an asymptomatic or erased form. They are not diagnosed, but are dangerous for the child and others, since an infected child spreads the infection. In some cases, something else joins the disease, for example, which leads to an exacerbation of staphylococcal infection and complications, in some cases very severe.

With staphylococcal infection, the incubation period lasts from 2-3 hours to 3-4 days. The shortest incubation period for gastroenterocolitic form of the disease.

Most often, staphylococcal infection in children is localized on the skin and in the subcutaneous cell. With skin staphylococcal infection, an inflammatory focus quickly develops with a tendency to suppuration and a reaction of regional lymph nodes according to the type of lymphadenitis and lymphangitis. In children, staphylococcal skin lesions, as a rule, have the appearance of folliculitis, boils, pyoderma, phlegmon, carbuncle, hydradenitis. Newborns may have exfoliative, pemphigus of newborns,. If the infection affects the mucous membranes, symptoms of purulent conjunctivitis, tonsillitis appear.

Staphylococcal tonsillitis in children as an independent disease is a rather rare phenomenon. This usually occurs against the background of SARS, in some cases due to exacerbation of chronic tonsillitis or as a result of sepsis.

With staphylococcal tonsillitis in children, continuous overlays appear on the palatine tonsils, sometimes they also affect the arches and tongue. In some cases, angina is follicular. Overlays with staphylococcal angina in most cases are purulent-necrotic, whitish-yellowish, loose. Removing them is relatively easy, as well as grinding between glass slides.

There are extremely rare cases when, with a staphylococcal infection, the overlays are dense, it is difficult to remove them, and the removal causes bleeding of the tonsils. For staphylococcal tonsillitis, diffuse bright hyperemia is characteristic, hyperemia of the mucous membranes of the pharynx without clear boundaries. The child may complain of severe pain when swallowing. The reaction of regional lymph nodes is expressed. Staphylococcal angina goes away for a long time. About 6-7 days persist symptoms of intoxication and elevated body temperature. Zev is cleared on the 5-7th day or on the 8-10th. Without laboratory methods, it is impossible to understand that angina is staphylococcal.

Staphylococcal laryngitis and laryngotracheitis are typical for children aged 1-3 years. They develop against the background of SARS. The disease is characterized by an acute onset, stenosis of the larynx quickly appears. Morphologically, there is a necrotic or ulcerative necrotic process in the larynx and trachea. Staphylococcal laryngotracheitis often resolves with obstructive bronchitis and, in rare cases, pneumonia. According to the symptoms, staphylococcal laryngotracheitis in children is almost the same as laryngotracheitis caused by other bacterial flora. The disease is very different only from diphtheria croup, which develops slowly, with a gradual change of phases, a parallel increase in symptoms (hoarseness, aphonia, dry, rough cough and a gradual increase in stenosis).

Staphylococcal pneumonia- a special form of lung damage with a characteristic tendency to abscess formation. Diseases are most susceptible to young children. It begins in most cases during or after SARS. As an independent disease not accompanied by others, staphylococcal pneumonia is extremely rare.

The disease begins acutely or violently, the body temperature is greatly increased, pronounced symptoms of toxicosis are observed. In more rare cases, staphylococcal pneumonia in children may begin gradually, first followed by small catarrhal phenomena. But even in these rare cases, the patient's condition quickly deteriorates sharply, the temperature "jumps" strongly, intoxication intensifies, and respiratory failure increases. There is lethargy and pallor of the child, he is drowsy, does not want to eat, burps, and often vomits. Shortness of breath, shortening of percussion sound, a moderate amount of small bubbling wet rales on one side and weakened breathing in the affected area are recorded.

With staphylococcal pneumonia, bullae form in the lungs. These are air cavities, the diameter of which is 1-10 cm. They can be identified by making an x-ray. Infection of the bull threatens with a lung abscess. A breakthrough of a purulent focus leads to purulent pleurisy and pneumothorax. With staphylococcal pneumonia, deaths are frequent.

With a primary staphylococcal focus of any localization, it may appear scarlatiniform syndrome. Most often this happens with staphylococcal infection of the wound or burn surface, lymphadenitis, phlegmon,.

The disease manifests itself as a scarlatiniform rash. It occurs on a hyperemic (reddened) background, is formed from small dots, and is located, as a rule, on the lateral surfaces of the torso. When the rash disappears, profuse lamellar peeling is observed. The child during this form of the disease has a high body temperature. The rash appears 2-3 days after the onset of the disease and later.

Lesions of the gastrointestinal tract by staphylococcus aureus can be located in various places (in the stomach, intestines, on the mucous membranes of the mouth, in the biliary system). The severity of these diseases also varies.

Staphylococcal stomatitis mostly young children are affected. There is a bright hyperemia of the oral mucosa, the appearance of aphthae or ulcers on the mucous membrane of the cheeks, on the tongue, etc.

Staphylococcal gastrointestinal diseases- this is gastroenteritis, enteritis, enterocolitis, which occur when infected through food. In children under 12 months of age, enteritis and enterocolitis often occur as secondary diseases against the background of another staphylococcal disease. If the route of infection is contact, and enteritis or enterocolitis occurs, there is a small amount of the pathogen in the body. Staphylococci cause local changes when they multiply in the intestines, as well as general symptoms of intoxication when the toxin enters the bloodstream.

With gastritis or gastroenteritis of a staphylococcal nature, the incubation period lasts 2-5 hours, followed by an acute onset of the disease. The most striking symptom is repeated, often indomitable, severe weakness, severe pain in the epigastric region, and dizziness. Most sick children have a fever. The skin is pale and covered with cold sweat, the heart sounds are muffled, the pulse is weak and frequent. In most cases, damage to the small intestine occurs, which leads to a violation of the stool. Defecation occurs 4 to 6 times a day, the stool is liquid, watery, there are impurities of mucus.

The most severe manifestation of staphylococcal infection is staphylococcal sepsis. It occurs more often in young children, mainly in newborns, in a special risk group - premature babies. The pathogen can enter the body through the umbilical wound, gastrointestinal tract, skin, tonsils, lungs, ears, etc. This causes the type of sepsis.

If staphylococcal sepsis is acute, the disease develops rapidly, the patient's condition is characterized as very severe. Body temperature is greatly increased, symptoms of intoxication are expressed. Petycheal or other rashes may be observed on the skin. Secondary septic foci (abscesses, abscessing pneumonia, purulent arthritis, skin phlegmon, etc.) appear in different organs. A blood test detects neutrophilic leukocytosis with a left shift of the formula, ESR is increased.

There is (very rarely) a lightning-fast course of the disease, which ends in death. But in most cases, the course is sluggish, with subfebrile temperature, mild symptoms of intoxication. Children are sweating, there is a lability of the pulse, bloating occurs, the liver can be enlarged, veins are dilated on the anterior abdominal wall and chest, and stool disorder is often among the symptoms. Sepsis in young children can present with a variety of symptoms, making it difficult to diagnose.

Staphylococcal infection in newborns and children of the 1st year of life associated primarily with the illness of the mother. Infection of the child occurs at any stage of pregnancy, during childbirth and after them.

Diagnosis of Staphylococcal infection in children:

Staphylococcal infection is diagnosed on the basis of the detection of purulent foci of inflammation. They resort mainly to laboratory research methods, since other diseases may have similar symptoms.

The microbiological method is often used to detect pathogenic staphylococcus in the lesion and especially in the blood. For serological diagnosis, RA with an autostrain and a museum strain of staphylococcus is used. The increase in antibody titer in the course of the disease undoubtedly indicates its staphylococcal nature. The titer of agglutinins in RA 1:100 is considered diagnostic. Diagnostic titers are detected on the 10-20th day of illness.

Among laboratory methods, a toxin neutralization reaction with an antitoxin is used. Today, RLA is often used instead of traditional methods.

Treatment of staphylococcal infection in children:

Treatment of patients with staphylococcal infection depends on each individual case. If the infection is mild in older children, doctors prescribe symptomatic remedies. For the treatment of severe and moderate forms of the disease, complex therapy is needed: antibiotics and specific anti-staphylococcal drugs (such as anti-staphylococcal plasma, anti-staphylococcal immunoglobulin, staphylococcal bacteriophage,).

Surgical methods, non-specific detoxifying therapy can be applied. Doctors often prescribe vitamins.

To cure or prevent dysbacteriosis, bacterial preparations are used, such as bifikol and others. It may also be necessary stimulating therapy, which will increase the protective functions of the child's body.

Patients with severe forms of staphylococcal infection are subject to mandatory hospitalization. It is also necessary to hospitalize newborns, even if the form of the disease is mild.

Antibacterial drugs such as semi-synthetic penicillinase-resistant penicillins, cephalosporins of the 3rd and 4th generation are used.

Acute sepsis, abscess destructive pneumonia, meningoencephalitis are treated simultaneously with two antibiotics at the maximum dose corresponding to the age of the patient.

Severe and generalized forms of staphylococcal infection, especially if the child is young, are treated with hyperimmune anti-staphylococcal immunoglobulin.

Staphylococcal gastroenteritis and enterocolitis are treated according to the same principles as other acute intestinal infections. Hospitalization is necessary if there are relevant clinical and epidemiological indications. Newborns and infants up to 12 months are placed in a separate box.

If the child is infected through mother's milk, breastfeeding should be discontinued. The child in such cases should be fed with donor milk, lactic acid or adapted mixtures in accordance with the age and severity of the gastrointestinal tract.

Food poisoning is treated by gastric lavage with 2% sodium bicarbonate solution on the first day from the onset of the disease. If toxicosis with dehydration is expressed, first you need to carry out infusion therapy, and then oral rehydration (restoration of water balance in the body).

Prevention of Staphylococcal infection in children:

In children's institutions, to prevent staphylococcal infection, a sanitary and anti-epidemic regime should be observed. This means that they disinfect household items, properly clean the premises, etc. Patients need to be identified and isolated in a timely manner so that they do not spread the infection.

It is also necessary to identify carriers of pathogenic multi-resistant strains of staphylococci among carers in maternity hospitals and departments for newborns and remove them from work, monitor compliance by staff with sanitary and hygienic rules for caring for a child, aseptic maintenance of individual nipples, care items and utensils, etc.

At least 2 times a year, maternity hospitals should be closed for disinfection and cosmetic repairs. In children's institutions, inspection of the staff of kitchen shops should be carried out daily. Personnel with any form of staphylococcal infection are not allowed to work - whether it is staphylococcal diseases of the upper respiratory tract, pustular diseases of the hands, or any other form.

Children with staphylococcal diseases are hospitalized in an individual box so as not to bring the infection to the hospital department. All care items for a sick child must be strictly individual.

Babies become less susceptible to staphylococcal infections when (provided that the mother is healthy). To date, there are no specific measures for the prevention of staphylococcal infection.

Which doctors should you contact if you have a staphylococcal infection in children:

Infectionist

Gastroenterologist

Dermatologist

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