Questions. An increased number of staphylococci in a smear in women
Staphylococcus aureus is a spherical or spherical bacterium. They are sedentary and gather in groups, so under a microscope they resemble a bunch of grapes.
Some of them long time live in the human body without causing harm. They are classified as opportunistic bacteria.
But if there are pathogenic staphylococci in the body and favorable factors for them, the development of serious diseases is possible.
These microbes are highly resistant to therapeutic methods treatment, are not afraid of temperature fluctuations, influence sun rays, frost. They do not die even when dried.
There are 27 types of staphylococci. In addition, all types of these bacteria are also classified into subspecies. Most of them are not dangerous to humans.
These species are the most harmful to the human body and provoke many diseases.
Staphylococcus secretes toxins that damage cells (exfoliatin), intoxicate the body (enterotoxin), and destroy leukocytes in the blood (leukocidin). They also produce enzymes that help microbes resist and multiply.
Most cases of staph infection occur in hospitals.
Causes of infections
Staphylococcus bacteria live in different places of the human body, absolutely not showing their presence until a certain point.
Interval incubation period ranges from 5 to 10 days. However, it can be reduced to 2 days or increase to a month or two.
Usually, the course of the inflammation process is characterized by a sluggish state that does not show obvious signs, but an acute form of manifestation is also possible. In some patients, the disease subsides from time to time, in others, on the contrary, it worsens.
Perhaps the spontaneous disappearance of the disease after a short period of time and the onset of the recovery phase. But in most cases, patients have a long-term course of chronic staph infection.
A huge variety of fungi and microorganisms coexist on the vaginal mucosa.
Streptococcal and staphylococcal infections in gynecology: etiology, symptoms and treatment methods
The vaginal microflora of a healthy woman contains about a hundred different microorganisms.
The share of opportunistic bacteria and fungi accounts for no more than 5%. In almost every second patient, streptococcus or Staphylococcus aureus is found in a smear.
A strong immune system inhibits the growth of colonies of these microorganisms, therefore, it is advisable to prescribe treatment only when an inflammatory process is detected in women, which is provoked by streptococcus or staphylococcus aureus.
Diseases caused by staphylococcus aureus
They can also cause a general infection of the entire human body.
Symptoms of staphylococcus in women
With the defeat of staphylococcus in women, it is noted:
- fever up to 39 °, chills;
- weakness;
- pain, swelling and hyperemia of the vaginal walls;
- loss of appetite;
- soreness in the lower abdomen;
- nausea, vomiting, diarrhea;
- development of sinusitis, sinusitis, frontal sinusitis, tonsillitis, pharyngitis;
- appearance purulent discharge from the infectious focus;
- itching, swelling and burning of the vulva;
- pain in the lower abdomen during urination, during intercourse;
- discharge serous secretions with an unpleasant putrid odor.
Often, women also experience a violation of the menstrual cycle or the onset of painful periods.
Staphylococcus in a smear in women is the detection of an opportunistic bacterium in the vaginal microflora. To identify it, it is necessary to take mucous secretions during a gynecological examination.
Staphylococcus in the vagina is usually found in a patient's smear during a routine examination by a gynecologist. Most often, staphylococcus enters the vagina with skin or intestines, when washing, when microorganisms can, under certain conditions, penetrate the mucous structures of the vagina. Sometimes Staphylococcus aureus can pass to a woman with various medical procedures and manipulations. can play an important role in the penetration of microbes intimate relationship- Staphylococcus aureus most often enters the woman's vagina during sexual intercourse.
The most common and dangerous of all varieties of this type of bacteria is Staphylococcus aureus. Penetrating into the human body, in particular into the woman's vagina, it may not manifest itself at all. But there are signs that help to identify the role of this microorganism in the appearance of a particular disease in a woman. For example, the invasion of these harmful bacteria can cause a disease such as vulvovaginitis in the fairer sex, the symptoms of which are as follows:
- The patient feels an unbearable burning sensation in the vagina.
- A strong pain syndrome develops.
- Over time, discharge appears that is not characteristic of the vagina.
- When the disease is neglected, yellow or orange scales may appear on the skin of a woman. This happens in very severe cases, when the disease begins to break out.
- When staphylococcus enters the urethra from the vagina, infection with microbes and the development of diseases in the genitourinary system of the patient can occur, which is most often detected due to the occurrence of a strong burning sensation when passing urine.
- Infection with staphylococcus vaginal structures most often causes the development of dysbacteriosis.
- Staphylococcus aureus that has entered the vagina can provoke recurrent thrush in a sick woman.
- On the labia of the patient, staphylococcus aureus causes severe itching, which constantly increases as the disease progresses.
- Often microorganisms of this type penetrate the vagina and begin to multiply there if there is a violation normal level acidity in vaginal structures.
How to deal with this serious disease?
Treatment of various diseases caused by Staphylococcus aureus begins with the diagnosis of the disease. At the first suspicion that this microorganism has entered the vaginal structures, a woman should be tested for the so-called bacterial culture (smear).
If the suspicions are confirmed, then the course of treatment should be prescribed and carried out by an infectious disease doctor. In such cases, the most commonly used following methods fight against Staphylococcus aureus:
- The patient is prescribed autovaccines of various types.
- The doctor recommends her to use toxoids.
- It is possible to use methods such as autohemotherapy.
- With local methods of dealing with Staphylococcus aureus, tampons containing bacteriophages are most often used.
What is used to destroy staphylococcus that has entered the vagina?
Simultaneously with these measures, the patient must increase immunity. This is achieved by the appointment of various drugs - probiotics. They restore the microflora destroyed by Staphylococcus aureus in the vagina of a sick woman.
If this recommendation is not taken into account, then during the subsequent cure of the patient, doctors may encounter big problems. Antibiotics must be chosen very carefully and changed frequently so that the staphylococcus cannot adapt to them.
Several methods have been developed to combat these microorganisms. Here is one of those ways:
- The patient is given a medicine called Amoxiclav 3 times a day for 10 days.
- Then they switch to the use of such a drug as Linex Bio.
- At the same time, to cure the patient, they use Hexicon suppositories (candles).
This method of dealing with a microorganism is very effective, since it cannot rebuild in time and adapt to any particular drug. Special vaginal suppositories or suppositories are selected with the expectation that they include the so-called bifidobacteria. If desired, a woman can buy a drug with these bacterial structures, dip a cotton swab into it and use it as an impromptu candle. Also, doctors often recommend to patients such suppositories that contain antibiotics. For example, Klindacin suppositories are very effective in coping with Staphylococcus aureus, but only the attending physician can prescribe them.
Self-medication here can only bring harm, since any minor mistake can lead to an even greater growth of staphylococcus colonies.
The timing of the course of therapy depends on the severity of the disease.
Usually, it may take from 2 weeks to a month to cure this type of microorganisms and the diseases provoked by them.
For particularly severe injuries healing process may take up to six months. If the diagnosis is correctly carried out and the right ones are selected medications, then in mild cases of infection with Staphylococcus aureus, some patients were cured in 10-12 days.
With the diagnosis of "staphylococcus" you should not panic, since almost all sick women sooner or later get rid of this unwanted "guest".
For whatever reasons, women do not communicate with a gynecologist, the examination begins with the fact that they take a swab from the vagina for examination for microbiological culture. The microflora of the vagina is represented by various bacteria - there are more than 100 species of them. A woman is considered healthy if 94-95% of this microflora is Dederlein sticks or lactobacilli.
If the smear contains a small amount of opportunistic microorganisms - cocci, but there is no inflammation - the number of leukocytes is normal - then cocci can be ignored.
An increase in the number of streptococci and staphylococci causes unpleasant symptoms, and during pregnancy can affect its outcome. If staphylococcus is detected during pregnancy - even with a slight increase in leukocytes - treatment is required.
Why is coccal flora dangerous and why is it necessary to get rid of it?
streptococci
Almost all adults are carriers of this conditionally pathogenic flora. If there are few of them, and they are on the surface of the skin and mucous membranes, then you should not worry.
But when it enters the body through microdamages and wounds, bacteria cause serious complications - rheumatism, glomerulonephritis, sepsis, meningitis ...
- Streptococcus strain A is especially dangerous. If it penetrates the body, it can provoke toxic shock.
- Strain B - most often found during pregnancy. These pathogens can cross the placenta, infect the fetus, which can lead to miscarriage.
- Hemolytic streptococcus. Place of localization - intestines and genitals. During pregnancy, it must be disposed of - infection of the baby can occur when it passes through birth canal. In the future, the baby may have dangerous complications.
The reason for the activation of streptococcal flora:
- antibiotic treatment;
- weakening of the immune system, regardless of the reasons that caused it;
- increased physical activity;
- stress;
- genital infections;
- neglect of hygiene measures or passion for douching.
During pregnancy, streptococci increase activity due to hormonal changes. In a healthy woman in the vaginal environment, the rate of streptococci is 104 CFU / ml.
Conditionally pathogenic bacteria are represented by strains:
- serological group B;
- green - viridans;
- enterococci - group D.
Strain A is absent.
If the norm is exceeded, then treatment is carried out with the use of antibiotics of general and local action. Antibiotics of the penicillin group are usually prescribed, but with allergic reactions they are looking for alternatives. During pregnancy, antibacterial drugs are administered by infusion.
After antibiotic therapy be sure to prescribe prebiotics and probiotics - to restore the intestinal and vaginal flora.
Staphylococci in a smear in women
Staphylococci are also opportunistic pathogens that are dangerous when introduced into the bloodstream against the background of a general decrease in immunity.
The most common are the following strains of these microorganisms. Staphylococcus aureus, or golden, got its name for the golden-colored toxins released by vital activity. This is the most dangerous view microbacteria, which provokes purulent-inflammatory processes in all tissues and organs.
During pregnancy, it is able to cross the placenta, infecting the fetus. For the production of a special enzyme - coagulase - it is also called coagulase-positive staphylococcus aureus.
Resistant to antibacterial drugs of the penicillin and cephalosporin series, it is very difficult to treat.
- Staphylococcus epidermidis, or epidermal, is introduced into the mucous membrane, causing conjunctivitis, sepsis, endocarditis and purulent infections urinary organs.
- Staphylococcus saprophyticus, or saprophytic, - prefers the external genital organs, provokes the occurrence of urethritis and cystitis in an acute form.
- Staphylococcus haemolyticus, or hemolytic, can invade any organ. It got its name because of its ability to destroy red blood cells. It is less common in humans than other strains.
If less than 1% of staphylococcus in a smear in women, no treatment is required. During pregnancy, a smear for microflora is taken several times - their increased number in the microflora of the birth canal can cause serious complications in the unborn baby.
Symptoms of staphylococcal infection of gynecological organs:
- the appearance of secretions with an unpleasant odor;
- a feeling of dryness of the vaginal mucosa, as a result of which sexual intercourse causes unpleasant and even painful sensations;
- burning in the genital tract, aggravated at night;
- pyoderma of the vaginal mucosa;
- increased irritability.
Especially dangerous increased activity staphylococcus during pregnancy.
Hemolytic staphylococcus causes inflammation of the urinary system, affects the respiratory system, intestines - it can penetrate into all organs and systems through the bloodstream. In pregnancy, treatment should begin with the detection of the sensitivity of this species. pathogen to antibiotics to reduce the risk of treatment. It is not difficult to eliminate hemolytic staphylococcus aureus - it is sensitive to antibacterial drugs from a number of penicillins, cephalosparins, lincosamides, macrolides ... Topical preparations are used at the same time.
During the 3rd trimester of pregnancy, it is possible symptomatic treatment with sanitation of the birth canal. Therapy of saprophytic and epidermal staphylococcus is similar to the inhibition of hemolytic activity.
Staphylococcus aureus during pregnancy in a smear
Increased activity of Staphylococcus aureus during pregnancy poses a serious threat to the fetus. It can infect the membranes of the fetal egg, provoke a miscarriage, infect the baby when passing through the birth canal, penetrate the mammary glands through the bloodstream and cause purulent mastitis.
Its entry into the bloodstream can stimulate very dangerous disease- endocarditis. During pregnancy, this condition can be fatal.
Treatment of pregnant women from Staphylococcus aureus is carried out using antibacterial drugs general and local action, immunomodulatory drugs and bacteriophages are required. All therapeutic measures are carried out only after receiving the results of a test for the sensitivity of staphylococcus to antibiotics - this strain of an opportunistic microorganism shows high resistance to antibacterial agents.
When staphylococcus enters the vagina, an inflammatory process may develop, which depends on the state of immunity. The disease causes pain, itching, burning, pathological discharge.
Among the etiology of various gynecological diseases, a significant role is occupied by bacterial infections. causes the development of the inflammatory process. It is important to treat this disease in time, preventing its chronicity and complications.
This infection in gynecology is found quite often. Most women are carriers of staphylococcus aureus, but with good local immunity, inflammation does not develop.
There are a number of factors contributing to inflammation:
- decrease in general and local immunity;
- hormonal imbalance;
- violation of vaginal acidity;
- improper treatment of infections;
- dysbacteriosis;
- gynecological diseases.
In the case of a decrease in the body's defenses, a pathological process develops, which is facilitated by trauma to the mucous membranes and a change in the pH of the vagina towards alkaline. Violation of the acid-base balance causes the death of lactic acid bacteria and the reproduction of opportunistic microflora.
The failure of the hormonal background is displayed on the condition of the mucous membranes of the vagina, because of which their protective function suffers, they become the entrance gate for infection.
Staphylococcus enters the vagina from the skin of the carrier. This bacterium often lives on the mucous membrane of the throat and causes the development of a sore throat. Infection occurs from another person through the sharing of hygiene items. As with other sexually transmitted infections, infection can occur during sexual intercourse.
If staphylococcus lives on the membranes of the throat, then one of the ways of infection is oral sex. You can become infected during hygiene procedures and medical procedures.
Infection occurs when taking a smear from the urethra, during ureteroscopy and other instrumental research methods. An important role is played by insufficient intimate hygiene when staphylococcus aureus is introduced from the skin around the intestines.
The incubation period takes an average of 5-10 days. Sometimes it can be reduced to 2 days or extended to a month, depending on the condition of the body and the activity of bacteria.
Symptoms
The course of the disease in women can be sluggish symptoms, without expressed clinical manifestations. In other cases, it develops acute symptoms inflammation, which makes a woman turn to a gynecologist with obvious complaints. 
In some cases, spontaneous recovery is possible, but more often the untreated process turns into a long-term one. chronic stage. The clinical picture of staphylococcal infection in women is largely similar to the manifestations of gonorrhea. Therefore, diagnosis and therapy should be carried out only by the attending gynecologist.
Typical symptoms of staph in the vagina are as follows:
- pain in the lower abdomen;
- burning and itching in the genitals;
- painful urination;
- yellow vaginal discharge with an unpleasant odor;
- pain in the lower back;
- disturbed menstrual cycle;
- discomfort during sexual intercourse;
- the appearance of pustular rashes on the genitals;
- development of candidal vaginitis.
- general malaise;
- fever;
- sleep disturbance.
A woman comes to a gynecologist's appointment with complaints about aching pain in the lower abdomen, lower back. Sexual contact becomes painful. When the infection spreads to the urethra and bladder painful urination occurs.
Menstruation passes with pathological discharge yellow color. This causes itching and burning in the perineum, a pungent odor appears. Of the violations of the menstrual cycle, a delay in menstruation is more often noted.
The development of vaginal candidiasis is indicated by the appearance curdled secretions. The general malaise is moderately pronounced, and the increase in body temperature can reach up to 38 degrees.
Treatment and prevention
To confirm the staphylococcal etiology of the disease, it is necessary to pass a swab from the vagina for bacterial culture. It is important to consult a doctor in time, and self-medication is unacceptable. Improper intake of drugs is fraught with complications and chronicity of the disease.
In addition to the isolation of staphylococcus, its sensitivity to antibiotics is determined, on which the choice of a particular drug depends. General treatment most commonly treated with antibiotics penicillin series and combined means. Preference is given to protected drugs (Amoxiclav, Flemoklav). 
Local therapy consists in the use of antibacterial suppositories: Livarol, Zalain. Vaginal tablets are used:
- Clotrimazole;
- Imidil;
- Antifungol.
Combined local treatment is carried out by douching with antiseptic solutions. For this, a pale solution of potassium permanganate, hydrogen peroxide, Miramistin is used.
Rehabilitation plays an important role in the complex of therapy. vaginal microflora. For this, vaginal tablets are prescribed:
- Ecofemin;
- Vagilak;
- Gynoflor.
For general strengthening of the body, combined preparations with minerals and vitamin complexes. Antihistamines are prescribed as symptomatic therapy to eliminate itching, swelling, and antipyretic purposes.
To achieve the maximum effect, as well as for the prevention reinfection examination and treatment of the sexual partner is necessary.
For the duration of the course of therapy, a pause in sexual activity should be made. During this period, the female body needs special diet, excluding fried, fatty and spicy food. In a month it is necessary to repeat the bacterial culture.
To prevent staphylococcal infection, you should take care of individual general and intimate hygiene. Preference should be given to natural underwear. During sexual intercourse, it is most reliable to protect yourself with condoms.
Conclusion
Staphylococcus aureus in the vagina is a common problem in gynecology and causes severe symptoms. For a favorable prognosis, it is important to prescribe the correct and timely treatment.
Staphylococci are one of the most common groups of microorganisms that combine saprophytes and pathogens in humans and animals. Despite the relative ease of detection of staphylococci in biological material from patients and objects environment, many difficulties arise in practice. This is due to the fact that staphylococci are representatives normal microflora Therefore, staphylococcus in a smear is not always an objective evidence of their etiological role in the development of the disease. It is also necessary to take into account the diversity of their manifestations, the degree of pathogenicity, wide variability under the influence of antibacterial agents, an extraordinary variety of clinical forms.
That is why the scheme for diagnosing and treating this infection cannot be universal, but should be developed taking into account the specifics of a particular nosological form of the disease. In addition, an important measure is the combined determination of qualitative and quantitative indicators of the content of pathogenic staphylococci in the test material.
Foodborne toxic infections of staphylococcal etiology, in terms of the number of cases, occupy one of the leading places among poisonings of a bacterial nature.
Norm of staphylococcus in a smear
Normally, staphylococcus must be present in the smear, since it is a representative of the normal microflora. His absence or low rate just as negatively affects the state of health, as well as overestimated indicators. As a norm, it is customary to consider an indicator up to 103 (10 in 3). Violation is any deviation, both in the direction of increasing the concentration, and in the direction of its decrease. An increase above this indicator is a pathological condition in which staphylococcus aureus is released into the environment, even with calm breathing.
Staphylococcus in a smear 10 in 3 - 10 in 5
The unit of measure for quantitative analysis is CFU / ml - the number of colony-forming units in 1 ml of the biological material under study.
To carry out calculations and determine the degree of seeding, first count the number of homogeneous colonies that have grown in a Petri dish after sowing. They should be identical in color and pigmentation. Then a recalculation is made from the number of colonies to the degree of seeding.
Let's look at a specific example. For example, if 20 cfu grew in a dish, this means that 0.1 ml of the test material contained 20 colonies of microorganisms. You can calculate the total amount of a microorganism as follows: 20 x 10 x 5 \u003d 1000, or 103 (10 in 3). In this case, it is assumed that 20 is the number of colonies that grew on a Petri dish, 10 is the number of colony-forming units per 1 ml, taking into account that only one tenth of the microorganisms was sown, 5 is the volume of saline in which it was diluted try.
The concentration of 104, (10 in 4), is determined in a similar way, which many experts consider as border state between the relative norm and a pronounced pathology, in which bacteremia and an acute inflammatory process develop. An indicator of 105 (10 in 5) is considered as an absolute pathology.
ICD-10 code
B95.8 Staphylococci, unspecified as the cause of diseases classified elsewhere
Causes of staphylococci in a smear
Staphylococcus within the normal range will always be detected in a smear, since it is a representative of the normal microflora. Therefore, from the point of view of bacteriology, it makes sense to discuss the reasons for the increase in the quantitative indicators of staphylococcus aureus. Thus, the concentration of staphylococcus increases primarily with reduced immunity. Normally, the immune system produces protective factors (histocompatibility complex, interferons, other immunoglobulins), which stimulate the normal state of the mucous membranes, prevent the uncontrolled reproduction of the bacterial flora, and inhibit active growth.
Another reason is dysbacteriosis. By virtue of various reasons the number of representatives of normal microflora decreases. As a result, a “free space” appears, which is immediately occupied by other microorganisms, including staphylococcus aureus. It is one of the first microorganisms to colonize free space and securely attach to it. As a result quantitative indicators increase sharply.
There are many reasons for dysbacteriosis. Perhaps the most important is the use of antibiotics, since there are practically no directed antibiotics that act purely on the causative agent of the disease. All of them are drugs with a wide spectrum of action. They affect not only a specific pathogen, but also the associated flora. Chemotherapy, antitumor treatment has a similar effect.
Hypothermia, overwork, constant nervous and mental strain, stress, non-compliance with the daily regimen contribute to a decrease in immunity and a violation of normal microflora. Inadequate and insufficient nutrition, lack of vitamins, microelements, bad habits, unfavorable living and working conditions are negatively reflected.
Staphylococcus aureus in a throat swab
A swab from the throat is taken during preventive studies for workers in the field of catering and child care, as well as for diagnosis infectious diseases(only if indicated). The main indication is the presence of inflammatory processes in the nasopharynx, pharynx.
The development of staphylococcal infection, food poisoning originates precisely from the oral cavity and pharynx. Often the microorganism persists in the area of the pharynx, nasopharynx, and the person does not even suspect about it, because on early stages the pathological process can be asymptomatic. However, its amount increases, which can subsequently result in chronic pathology, severe inflammation, sore throat, swollen lymph nodes. In addition, at an increased concentration of the microorganism, it is released into the environment. As a result, a person becomes a bacteria carrier. At the same time, the person himself may not get sick, but he infects the people around him.
When staphylococcus is detected in a throat swab, people are not allowed to work in food factories, culinary workshops, canteens, which helps to avoid food intoxication. Also, bacteria carriers are not allowed to work with children, especially for children of early, preschool, younger age. Mandatory sanitation
Identification of the exact concentration of staphylococcus in a smear makes it possible to accurately determine the pathogen and diagnose the pathological process, and choose the optimal treatment.
The sampling of material for research is carried out using a sterile swab, by passing it over the surface of the palatine tonsils. Be sure to take the material on an empty stomach, or not earlier than 2-3 hours after eating. Be sure to take the material before antibiotic therapy, otherwise the results will be distorted.
Then, in the laboratory conditions, the test material is sown on nutrient media. It is necessary to sow the material within the next 2 hours after the fence. Milk-salt agar, yolk agar is considered the optimal medium for sowing staphylococcus aureus.
Staphylococcus aureus in a nasal swab
A swab from the nose is taken during the study certain categories workers (work with children, in the field of public catering). The fence is made with a sterile swab from the nasal mucosa. At the same time, a separate tampon is used for each nostril. Wherein nasal cavity should not be processed by anything, washings should not be carried out the day before. The sampling is done before antibiotic therapy, otherwise the result will be invalid.
The analysis is done on average 5-7 days. After taking the material, it is sown directly on the surface of the nutrient medium. For sowing, 0.1 ml of flush is used. It is convenient to use Baird-Parker medium, on which staphylococcus colonies are very easy to recognize by their opalescent sheen, black colonies. In general, the choice of environment is determined by the laboratory assistant, depending on the provision of the laboratory and the individual objectives of the study, specialization and degree of qualification. The ratio of inoculum and nutrient medium is 1:10. Then incubated under thermostatic conditions.
Then, on day 2-3, re-seeding is carried out on a slant agar, a pure culture is isolated. They spend with her further research(biochemical, immunological), the main properties are determined, the culture is identified, the concentration is determined, if necessary, sensitivity to antibiotics.
Separately, microscopy is carried out, which makes it possible to determine an approximate preliminary assessment of the smear, to identify the species of the microorganism by characteristic morphological and anatomical features. You can also detect other signs of pathology: signs of inflammation, neoplasms.
A person is given only a finished result indicating the type of microorganism, the degree of contamination, and sometimes sensitivity to antibacterial drugs.
Staphylococcus aureus in a vaginal smear
They are found because they are permanent inhabitants of the skin and mucous membranes. Diseases that cause staphylococci are in the nature of autoinfection, that is, they develop with a change in the main parameters of the human biochemical cycle, changes in hormonal levels, microflora, damage to the mucous membranes, and pregnancy. Less commonly, they are the result of exogenous penetration of infection (from the external environment).
Staphylococcus in a smear from the cervical canal
They can be detected against the background of dysbacteriosis that develops during pregnancy, a decrease in microflora, and a violation of the hormonal cycle. Since staphylococci are characterized by a wide range of sources of infection and multi-organism, they can be easily transported with the blood and cause inflammation outside the main source. Often the development of a staphylococcal infection is a consequence of antibiotic therapy, physiotherapy, and surgical interventions.
Risk factors
The risk group includes people with a pathological focus of infection in the body. For example, a staphylococcal infection can develop in the presence of caries in the oral cavity, inflammation of the tonsils, chronic and not completely cured diseases. respiratory tract, urinary organs, in the presence of purulent-septic wounds, burns, damage to the skin and mucous membranes. Great danger represent catheters, implants, grafts, prostheses, since they can be colonized by staphylococcal infection.
The risk factor is reduced immunity, a violation of the condition endocrine system, dysbiosis, diseases of the gastrointestinal tract. The risk group also includes people who have recently had surgical intervention, after serious illnesses, after antibiotic therapy, chemotherapy.
A separate group consists of people with immunodeficiencies, AIDS, other infectious diseases, autoimmune pathologies. Newborn children are at risk (due to the unformed microflora and immune system), pregnant women (against the background of hormonal changes). Women in labor and childbirth, since nosocomial strains of staphylococcus that live in the external environment are currently a serious danger in hospitals and maternity hospitals, have acquired multiple resistance and increased pathogenicity. They are easy enough to get infected.
The risk group includes people who do not observe the daily routine, do not eat enough, are exposed to nervous and physical stress and overstrain.
A special group is represented by medical staff, biologists, researchers who work with various cultures of microorganisms, including staphylococcus aureus, have contact with biological fluids, tissue samples, feces, are in constant contact with both infectious and non-infectious patients.
This should also include laboratory assistants, nurses, nurses, employees of sanitary inspection bodies, pharmacists, developers of vaccines and toxoids, and their testers. Also at risk are agricultural workers who deal with animals, livestock and poultry slaughter products, which also act as a source of infection.
Symptoms of staphylococci in a smear
Symptoms directly depend on the localization of the focus of infection. So, with the development of a respiratory tract infection, colonization of the mucous membrane of the oral cavity and nasopharynx occurs first. This manifests itself in the form of inflammation, swelling, hyperemia. There is pain when swallowing, perspiration, burning in the throat, nasal congestion, a runny nose joins with the release of yellow-green mucus, depending on the severity of the pathology.
As you progress infectious process, signs of intoxication develop, the temperature rises, weakness appears, the overall resistance of the body decreases, immunity decreases, as a result of which the pathological process only worsens.
Signs of systemic organ damage may develop. In the descending respiratory tract, the infection descends, causing bronchitis, pneumonia, pleurisy with a strong cough, copious sputum.
With the development of infection in the genitourinary tract and reproductive organs, first develops irritation of the mucous membranes, itching, burning, hyperemia appears. Gradually, the pathological process progresses, inflammation, pain, discharge appear. white color with a specific smell. There is pain when urinating, burning. The progression of the disease leads to the development of an intense infectious process that extends to the area of the rectum, perineum, internal organs.
With the localization of the inflammatory process on the skin and the wound surface, the wound fester, a specific smell appears, the local, and then the local and general body temperature may increase. The focus of infection is spreading all the time, the wound "gets wet", does not heal, grows all the time.
With the development of a staphylococcal infection in the intestinal area, there are signs food poisoning: there is nausea, vomiting, diarrhea, indigestion, stool, loss of appetite. There is pain and inflammation in the gastrointestinal tract: gastritis, enteritis, enterocolitis, proctitis. With the generalization of the inflammatory process and the increase in signs of intoxication, the body temperature rises, chills and fever develop.
First signs
Known early symptoms that are harbingers of the disease. They develop as the concentration of staphylococcus in the blood increases, and appear long before real symptoms appear.
So, the development of a staphylococcal infection is accompanied by an increase in heart rate and breathing, tremors appear in the body, chills, and fever. When walking, increased load, there may be a load on the heart, lungs, there is a slight shortness of breath. May appear headache, migraine, nasal congestion, ears, less often - tearing, perspiration and dryness in the throat, dry skin and mucous membranes.
There is often a feeling elevated temperature, however, when measured, it remains normal. A person quickly gets tired, working capacity decreases sharply, irritation, tearfulness, drowsiness appear. Concentration and ability to concentrate may decrease.
Staphylococcus aureus in a smear
Staphylococcus aureus, S. aureus, is a frequent causative agent of inflammatory and infectious diseases of the internal organs of humans and animals. More than 100 nosological forms of diseases caused by this pathogen are known. The pathogenesis of Staphylococcus aureus is based on a whole complex of toxic substances and factors of aggression, enzymes that are produced by microorganisms. In addition, it was found that the pathogenicity of the microorganism is due to genetic factors and the influence of the environment.
It is worth emphasizing that Staphylococcus aureus has multiple organ tropism, that is, it can become a pathogen pathological process in any organ. This is manifested in the ability to cause purulent-inflammatory processes in the skin, subcutaneous tissue, lymph nodes, respiratory tract, urinary system, and even the musculoskeletal system. Is a common causative agent food poisoning. The special significance of this microorganism is determined by its role in the etiology of nosocomial infections. Among Staphylococcus aureus, methicillin-resistant strains often occur, which are highly resistant to the action of any antibiotics and antiseptics.
In a smear, it is quite easy to recognize, since it looks like gram-positive cocci, the diameter of which varies from 0.5 to 1.5 microns, arranged in pairs, in short chains or clusters in the form of a bunch of grapes. Motionless, do not form spores. Grow in the presence of 10% sodium chloride. Surface structures are capable of synthesizing a number of toxins and enzymes that play important role in the metabolism of microorganisms and determine their role in the etiology of staphylococcal infections.
It is also easy to recognize in a smear by such morphological features as the presence of a cell wall, membrane structures, a capsule and a flocculating factor. An important role in pathogenesis is played by agglutinogen A, a protein that is evenly distributed over the entire thickness of the cell wall and is connected to peptidoglycan by covalent bonds. The biological activity of this protein is diverse and is an unfavorable factor for the macroorganism. Able to react with mucosal immunoglobulin, form complexes, which are accompanied by damage to platelets and the development of thromboembolic reactions. It is also an obstacle to active phagocytosis, contributes to the development of an allergic reaction.
Epidermal staphylococcus in a smear
For a long time it was believed that Staphylococcus epidermidis was not pathogenic. But recent research has confirmed that this is not the case. It is a representative of the normal microflora of the skin and can cause disease in some people. This is especially true for people with reduced immunity, after burns, damage to the integrity of the skin, with various injuries. As a result of the development of a staphylococcal infection, a purulent-septic inflammatory process develops quite quickly, zones of necrosis, erosion, ulcers, and suppuration appear.
In a smear, it is quite easy to recognize by the formation of pigmented colonies, up to 5 mm in diameter. They form the form of cocci, can be single or combine into polycompounds resembling bunches of grapes. They can grow in both aerobic and anaerobic conditions.
Hemolytic staphylococcus in a smear
The hemolytic properties of staphylococcus is its ability to lyse blood. This property is provided by the synthesis of plasmacoagulase and leukocidin - bacterial toxins that break down the blood. It is the ability to split and coagulate plasma that is the leading and constant criterion by which pathogenic staphylococci fairly easy to identify.
The principle of the reaction is that plasmocoagulase reacts with the plasma Co-factor, forms coagulase thrombin with it, which converts thrombinogen into thrombin with the formation of a blood clot.
Plasmocoagulase is an enzyme that is quite easily destroyed by the action of proteolytic enzymes, for example, trypsin, chemotrypsin, as well as when heated to a temperature of 100 degrees and above for 60 minutes. Large concentrations of coagulase lead to a decrease in the ability of blood to coagulate, hemodynamics are disturbed, oxygen starvation fabrics. In addition, the enzyme promotes the formation of fibrin barriers around the microbial cell, thereby reducing the efficiency of phagocytosis.
Currently, 5 types of hemolysins are known, each of which has its own mechanism of action. Alpha toxin is not active against human erythrocytes, but lyses erythrocytes of sheep, rabbits, pigs, aggregates platelets, has a lethal and dermonecrotic effect.
Beta-toxin causes lysis of human erythrocytes, exhibits a cytotoxic effect on human fibroblasts.
Gamma toxin lyses human red blood cells. Its lytic effect on leukocytes is also known. It does not have a toxic effect when administered intradermally. At intravenous administration leads to death.
Delta toxin differs from all other toxins in its thermolability, wide range of cytotoxic activity, damages erythrocytes, leukocytes, lysosomes and mitochondria.
Epsilon toxin provides the widest possible area of effect, lysing all types of blood cells.
Coagulase-negative staphylococcus in a smear
The significance of coagulase-negative staphylococci in the development of the pathology of internal organs is beyond doubt. According to the researchers, this group is responsible for the development of the pathology of the urogenital tract in about 13-14% of cases. They are the causative agents of skin and wound infections, conjunctivitis, inflammatory processes and sepsis in newborns. The most severe form of infection is endocarditis. The number of such complications has especially increased due to the high prevalence of heart surgery during the installation of artificial valves and shunting of blood vessels.
Considering the biological properties, it is worth noting that microorganisms are cocci with a diameter of no more than 5 microns, do not form pigments, and can grow both under aerobic and anaerobic conditions. Grow in the presence of 10% sodium chloride. They are capable of hemolysis, nitrate reduction, possess urease, do not produce DNase. Under aerobic conditions, they are able to produce lactose, sucrose, and mannose. Not capable of fermenting mannitol and trehalose.
The most significant is Staphylococcus epidermidis, which is one of the leading clinically significant pathogens. Causes septicemia, conjunctivitis, pyoderma, infections urinary tract. Also among the coagulase-negative strains there are many representatives of nosocomial infections.
Staphylococcus saprophyticus, saprophytic in a smear
Refers to coagulase-negative strains that are capable of existence, both in aerobic and anaerobic conditions. Actively multiply in the wound surface, in damaged areas of the skin, with severe burns, at foreign body in soft tissues, in the presence of transplants, prostheses, in invasive procedures.
Often lead to the development toxic shock. This effect is due to the action of endotoxins. It often develops when using sorbent tampons in women during menstruation, in the postpartum period, after abortions, miscarriages, gynecological operations, after prolonged use of barrier contraception.
The clinical picture is represented by a sharp increase in temperature, nausea, sharp pains in muscles and joints. Later, characteristic spotty rashes appear, most often generalized. Developing arterial hypotension accompanied by loss of consciousness. Mortality reaches 25%.
Fecal staphylococcus in a smear
It is the main causative agent of food poisoning. Well preserved in the environment. The main route of transmission is fecal-oral. Released into the environment with stool. It enters the body with poorly cooked food, dirty hands, unwashed products.
The mechanism of action is due to staphylococcal enterotoxins, which are thermostable polypeptides formed during the reproduction of enterotoxigenic strains, staphylococci in food, intestines and artificial nutrient media. They show high resistance to the action of food enzymes.
The enteropathogenicity of toxins is determined by their association with the epithelial cells of the stomach and intestines, the impact on the enzymatic systems of epitheliocytes. This, in turn, leads to an increase in the rate of formation of prostaglandins, histamine, an increase in the secretion of fluids into the lumen of the stomach and intestines. In addition, toxins damage the membranes of epithelial cells, increasing the permeability of the intestinal wall to other toxic products of bacterial origin.
The virulence of fecal enteropathogenic staphylococci is regulated by the genetic apparatus of the bacterial cell in response to environmental factors, which allows the microorganism to quickly adapt to environmental conditions, which allows the microorganism to quickly adapt to changing conditions when moving from one microbiocenosis to another.
Differential Diagnosis
When determining the role and significance of various representatives of the genus Staphylococcus in the etiology of pyoinflammatory diseases in humans, despite their relative simplicity, their detection is associated with numerous difficulties. This is due to the fact that staphylococcus is a representative of the normal microflora that inhabits various biotopes of the human body. It is necessary to clearly distinguish between endogenous staphylococcus, which develops inside the body, and endogenous, which penetrates the body and from the environment. It is also important to understand which of the biotopes human body is typical for it, and where it is a representative of the transient flora (introduced by chance).
It is also important to take into account the high variability of the microorganism under the influence of various factors, including antibiotics. A wide variety of clinical manifestations and nosological forms is taken into account. Therefore, a universal scheme for the diagnosis of staphylococcal infection. It is easier to examine those biological media that are normally sterile (blood, urine, cerebrospinal fluid). In this case, the detection of any microorganism, colony is a pathology. The most difficult is the diagnosis of diseases of the nose, pharynx, intestines, the study of bacteriocarrier.
In its most general form, the diagnostic scheme can be reduced to the correct sampling of biological material, its bacteriological primary inoculation on an artificial nutrient medium. At this stage, preliminary microscopy can be performed. By studying the morphological, cytological features of the sample, it is possible to obtain certain information about the microorganism, to carry out at least its generic identification.
Some doctors prefer to use drugs a wide range actions, while others prescribe antibiotics to their patients, aimed solely at eliminating gram-positive infections, including staphylococcus aureus. The choice is determined mainly by the results of the analysis for antibiotic sensitivity, as a result of which the most effective drug is determined and its optimal dosage is selected.
In some, mild cases, antibiotic therapy may not be needed to correct the condition. You may just need to normalize the microflora. This is observed with dysbacteriosis. In this case, probiotics, prebiotics are prescribed, which normalize the state of the microflora by reducing the amount of pathogenic flora and increasing the concentration of representatives of the normal microflora.
Symptomatic therapy is rarely used, as it is usually sufficient to eliminate the infection, and concomitant symptoms disappear on their own. In some cases, additional measures are prescribed, for example: painkillers, anti-inflammatory, antihistamines, antiallergic drugs. At skin diseases external means are used: ointments, creams. Physiotherapy, folk and homeopathic remedies can be prescribed.
Vitamin therapy is not carried out, since vitamins act as growth factors for microorganisms. The exception is vitamin C, which must be taken at a dosage of 1000 mg/day (double dose). This will increase immunity, resistance, resistance of the body to the effects of adverse factors.
Medications
The treatment of infectious diseases must be taken seriously. Self-medication can not be engaged, often it has disastrous consequences. It is necessary to take into account many nuances before proceeding with treatment. The best thing to do is only a doctor.
It is important to take precautions: do not treat the infection "blindly", even with pronounced clinical picture. It is necessary to carry out bacteriological examination, isolate the causative agent of the disease, select the most optimal antibiotic directly to it, determine the required dosage, which will completely suppress the growth of the microorganism.
It is also important to complete the full course, even if the symptoms have disappeared. This is because if the treatment is abandoned, the microorganisms will not be completely killed. Surviving microorganisms will quickly acquire resistance to the drug. Repeated use will render it ineffective. Moreover, resistance to the entire group of drugs, and to similar drugs (due to the development of cross-reaction), will develop.
Another important precaution is that you cannot reduce or increase the dosage on your own. The reduction may not be effective enough: the bacteria will not be killed. Accordingly, they are short time mutate, acquire resistance and a higher degree of pathogenicity.
Some antibiotics can also have side effects. The stomach and intestines are especially sensitive to antibiotics. Gastritis, dyspeptic disorders, stool disorders, nausea may develop. Some adversely affect the state of the liver, so they need to be taken in conjunction with hepatoprotectors.
The following are antibiotics that have worked well in treating staph infections with minimal side effects.
Amoxiclav is effective in the treatment of staphylococcal infections of any localization. It is used in the treatment of diseases of the respiratory tract, genitourinary system, intestines. Take 500 mg per day for three days. If necessary, the course of treatment is repeated.
Ampicillin is prescribed mainly for diseases of the upper and lower respiratory tract. The optimal dosage is 50 mg/kg body weight.
Oxacillin is effective both in local inflammatory processes and in generalized infections. Is reliable prevention sepsis. 2 grams are prescribed every 4 hours. Enter intravenously.
For purulent-inflammatory skin diseases, chloramphenicol ointment is applied externally, applying it in a thin layer to the damaged surface. Also inside take levomycetin 1 gram three times a day. With a strong generalization of the infectious process, chloramphenicol is administered intramuscularly, 1 gram every 4-6 hours.
Candles from Staphylococcus aureus
Used mainly for gynecological diseases, infections of the genitourinary tract, less often - with intestinal dysbacteriosis with inflammation of the rectum. Only a doctor can prescribe suppositories and select the optimal dosage, since with misapplication high risk of complications and further spread of infection. Candles are not prescribed without preliminary tests. The indication for their use is exclusively staphylococcus aureus in a smear.
It's important to know!
Staphylococcal laryngitis and laryngotracheitis develop, as a rule, 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 the rapid appearance of stenosis of the larynx. Morphologically, a necrotic or ulcerative-necrotic process in the larynx and trachea is noted.