Staphylococcus aureus bacteraemia Flashcards
Describe features of staphylococcus aureus
It is a gram positive cocci which is coagulase positive. It causes skin infections, abscesses, osteomyelitis, toxic shock syndrome
What are the potential sources for a S.aureus bacteraemia?
- Skin/soft tissue,
- Surgical site,
- Vascular device,
- Indwelling line/prosthesis,
- Bone/joint/spine infections
- Endocarditis,
- Pacemaker
- IVDU
What are is the presentation of S.aureus bacteraemia?
Fever, tachycardia, painful swollen skin or leaking wound
What are the investigations for s.aureus bacteraemia?
- Blood culture (add another 2 sets if endocarditis is suspected) and bloods
- Samples of sputum/pus/urine,
- Refer for transthoracic echocardiogram and then refer to cardiology if it suggests endocarditis
- Repeat blood cultures after 48 hours of starting abx.
What is the management of S.aureus bacteraemia?
- IV flucloxacillin is methicillin sensitive
- IV vancomycin if MRSA or penicillin allergy
When do you IVOST a patient with S.aureus bacteraemia?
After 2 weeks
What is staphylococcal toxic shock syndrome?
A severe systemic reaction to staphyloccocal exotoxins. It presents with fever >38.9. Hypotension <90 systolic, diffuse erythematous rash, desquamation rash, involvement of 3+ organ systems: diarrhoea and vomitign, mucus membrane erythema, hepatitis, thrombocytopenia, CNS involvement
What is the management of staphylococcal toxic shock syndrome?
- Removal of infection focus,
- IV fluids,
- IV antibiotics
What is staphylococcal scalded skin syndrome?
Severe desquamating rash affecting those under age 5.
What is the presentation of SSSS?
Superficial fluid filled blisters, desquamation, perioral crusting/fissuring, erythrodermic skin and fever. Diagnosis is clinical but can do skin biopsy to rule out TEN.
What is the treatment of SSSS
IV antibiotics, clindamycin which inhibits toxin synthesis. Also supportive care with fluid replacement, pain management and careful wound care.
