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What Is A Staph Infection?
Staphylococcus—also called staph—is a type of bacteria that causes a wide range of infections if it spreads into your bloodstream or internal tissues. Staph infections are very contagious and can spread through direct contact. Your risk of these infections increases if you're hospitalized or work in a hospital, have a chronic condition, or recently had surgery. Fortunately, there are steps you can take time prevent getting an infection.
The symptoms of a staph infection depend on where the bacteria spread. Skin and tissue staph infections are the most common, though staph can also spread to your blood, heart, or other organs, causing serious diseases. There are several treatments available to reduce your symptoms, but your exact treatment plan will depend on the severity of your infection.
There are more than 30 types of staph bacteria. Staphylococcus aureus, or S. Aureus is the strain that causes the most infections. Each type of S. Aureus is categorized based on how effective certain antibiotics can treat them: Methicillin-resistant S. Aureus (MRSA): MRSA bacteria are resistant to methicillin antibiotics, making them more difficult to treat. MRSA most commonly spreads in hospital or clinical environments. Methicillin-susceptible S. Aureus (MSSA): This type of infection most commonly affects the skin. Unlike MRSA, methicillin antibiotics can treat this type. Vancomycin-intermediate S. Aureus (VISA): VISA is a type of staph infection that's somewhat resistant to the antibiotic Vancocin (vancomycin). This infection is most common in those who've had surgery, catheters, or a previous infection with MRSA. Vancomycin-resistant S. Aureus (VRSA): These bacteria are completely resistant to Vancocin (vancomycin). Like VISA, VRSA infections are typically a complication of surgery or catheter use and are more prevalent in people who have an underlying lung disease. Staph infections range in severity from mild to life-threatening. The symptoms you have depend on the body system that's affected by the bacteria. Skin Symptoms Most staph infections affect the skin. Typical signs of these infections are pus-filled boils or pimples that appear anywhere on your body. Over time, these boils can become swollen and burst. Some of the most common types of skin-related staph infections include: Impetigo: Mostly affects young children and causes sores around the mouth or nose or on the limbs, which can break, drain pus, and form honey-colored scabs Cellulitis: Causes redness, inflammation, and pain on the skin that is warm to the touch Folliculitis: Affects the hair follicles and causes redness, itchiness, and soreness Blood Symptoms Also known as bacteremia or sepsis, staph infections of the blood are severe and life-threatening. They cause at least one of the following symptoms: Elevated heart rate or weak pulse Confusion or disorientation Severe pain or aches Fever Chills or shivers Difficulty breathing Clammy or sweaty skin Digestive Symptoms Staph bacteria can also cause food poisoning, leading to: Heart Symptoms Staph infection of the heart, or endocarditis, causes inflammation of the heart valves. This rare, dangerous condition causes: Other Symptoms Staph infections can also affect other systems in your body including your breasts, bones, and lungs. As a result, you might experience the following symptoms: Breasts: Can spread if you're breastfeeding and cause swelling, redness, pain in the breast, and flu-like symptoms Bones: Causes pain, swelling, redness, chills, and fever Lungs: May lead to pneumonia which can cause persistent cough, high fever, chills, chest pain, and difficulty breathing The bacteria that cause staph infections, S. Aureus, occur in the nasal passages or on the skin, causing no problems in most cases. Infections happen when these bacteria enter the bloodstream—via cuts or wounds or by mouth—and your immune system isn't able to fight them off. There are several ways that staph bacteria spreads. You can come into direct contact with the infection if you touch a person's pus or skin, infected surfaces, or objects like towels, razors, clothing, or doorknobs. In some cases, contaminated food can also spread the infection. Risk Factors Your chances of developing a staph infection are higher if you: Work in a hospital or were recently hospitalized Are using a catheter, breathing tube, or feeding tube Have a chronic condition like diabetes, cancer, lung disease, or HIV Are undergoing chemotherapy Have an implant, such as a pacemaker or artificial joint Are on dialysis, a common kidney treatment to clean your blood Use injection drugs Have severe or extensive burns on your body Play contact sports or share athletic equipment The way your healthcare provider approaches diagnosis for staph infections also depends on the part of the body that's infected. Their goal is to figure out what's causing the symptoms and rule out other possible causes, such as diabetes, wound infections, and certain heart problems. When you go in for an appointment with your provider, they will ask about your medical history and perform a physical exam. They will likely also use other tests to make a diagnosis, including: Bacterial culture: Takes a sample of your skin, stool, breastmilk, or nasal or throat swab to test for staph bacteria DNA or RNA tests: Tests, such as real-time polymerase chain reaction (RT-PCR), are newer methods to detect signs of bacterial genetics (DNA or RNA) from tissue, blood, or fluid samples Echocardiogram: A form of imaging that looks at blood flow in the heart to check for staph infections in the heart Computerized tomography (CT) scan: If the provider thinks the infection may have spread to other organs, they can detect bacteria by using this test to produce detailed images of your organs Chest X-ray: Chest imaging can check for fluid build-up in the lungs which may occur as a result of a lung staph infection Healthcare providers prescribe antibiotics to treat staph infections. In some cases, additional treatments may help reduce symptoms. In severe cases, you may need to be hospitalized. Topical Antibiotics For some skin staph infections, you can apply antibiotic creams or ointments directly to the wound. These treatments are available over the counter or with a prescription. The most common creams include Fucidin (fucidic acid) and Bactoban (mupirocin). Oral Antibiotics For staph infections that affect other parts of the body, healthcare providers prescribe antibiotic medication that you can take by mouth. The most common antibiotics inlcude: Bactocil (oxacillin) Kefzol (cefazolin) Nallpen (nafcillin) Avelox (moxifloxacin) Rifadin (rifampin) Firvanq (vancomycin) Zyvox (linezolid) Intravenous (IV) Antibiotic Therapy In severe or complicated cases, such as when the infection has spread to multiple body systems, you may need to take antibiotics in the hospital through an IV. These treatments are extensive and can last up to 4 to 6 weeks. Fluid Drainage If you have an infected wound or severe boils, your healthcare provider may drain the fluid to reduce pain and inflammation. Keep in mind: you should not do this on your own. Fluid drainage should only be done by a licensed professional in a hospital or clinical environment. The goal of preventing a staph infection is to limit exposure to the bacteria. Several strategies and lifestyle changes can prevent you from experiencing symptoms, including: Frequently washing your hands, especially if touching potentially contaminated surfaces Wearing gloves and keeping your hands clean if you work in a hospital or clinical environment Not sharing athletic equipment or cleaning it off before and after use Preparing food safely and fully cooking it Properly cleaning and disinfecting cuts or wounds on your skin Keeping cuts or wounds covered with sterile bandages If staph infections go untreated, they have the potential to lead to severe and life-threatening complications. These include toxic shock syndrome, septic shock, heart failure, fluid-filled abscesses in the heart valves, and stroke. That said, if you're experiencing symptoms of a staph infection or notice new wounds on your skin, it's essential to see your healthcare provider as soon as you can to treat your infection and reduce your risk of complications. Staph infections are bacterial infections that most commonly affect your skin. But, they can also affect your bloodstream, digestive system, bones, lungs, and heart. When the infection affects your skin, you might experience pus-filled boils or blisters. But when the infection occurs in other parts of your body, symptoms can be more serious. Fortunately, staph infections are preventable and treatable. Washing your hands, cleaning cuts on your skin, and preparing food properly are some ways to prevent experiencing symptoms. If you do develop the infection, topical ointments, antibiotics, and other medical treatments can help improve symptoms.AAO 2023: Latest Diagnostic And Therapeutic Advancements In Ocular Infections
Penny Asbell, MD, FACS, spoke with Ophthalmology Times about her poster on results from the ARMOR Study and latest diagnostic and therapeutic advancements in ocular infections at this year's American Academy of Ophthalmology meeting.
Penny Asbell, MD, FACS, spoke with Ophthalmology Times about her poster on results from the ARMOR Study and latest diagnostic and therapeutic advancements in ocular infections at this year's American Academy of Ophthalmology meeting.
Video TranscriptEditor's note - This transcript has been edited for clarity.
Penny Asbell, MD, FACS:Hi. You know, what could be worse? An eye infection, something we all dread, and we definitely want to treat right away. So the ARMOR study is a surveillance study done in the United States. And we take that data and we look at antibiotic resistance. So we've looked at isolates from 2009 to 2022. We have 370 isolates from either an aqueous sample or vitreous sample to analyze.
What did we find out? Staph aureus, and coagulase-negative staph, which includes staph epidermidis, lots of resistance, specifically methicillin resistance, it's over 40%, when you look over that time period. Okay, the other important thing is, not only do you see a lot of resistance, methicillin resistance, but if you take those isolates, and then look at other antibiotics, over three-quarters of them are resistant to multiple antibiotics, so it's gonna make it hard to pick the right antibiotic to get going. And that's one of the reasons that ARMOR can be useful. If you look at the MIC data, which is a laboratory data of potency, you see one good news: vancomycin seems to be pretty good from 2009, all through 2022. The other good news is one of the commercially available antibiotics, besifloxacin, seems to be pretty good too, during that same period, so we have some options. But the one thing to think about is, if you see serious infection, get a culture. And then you have to figure out how to get started with treatment, and that's where the ARMOR surveillance study can be really useful.
Surveillance studies tell us a little bit about what's going on. So we stay up to date on treatment, and can get started. And then we can modify or change depending on our culture results. So hopefully, you'll take a look at the ARMOR results that are available publicly, and you can figure out how to get going and make sure those infections get treated right away. And of course, decrease the likelihood if possible, as well.
We know why infections can't wait. We want to treat them right away. And we want to pick the best treatment almost immediately. One of the things that the ARMOR has showed us is, what is the antibiotic resistance pattern? It's that surveillance studies, it's been done year after year from 2009 through 2022. And with that data we've been able to develop what are the resistant trends over a period of time.
So first question is, why is antibiotic resistance so important? I think there are two take homes there. One, the more antibiotics we use, the more resistance we get. And two, we're really not seeing a lot of new antibiotics being created. So we got to make the best use of the ones we have. Now some people say, "Hey, this is a global problem, but is it really an eye problem?" Well, unfortunately, 2023 has definitely told us that antibiotic resistance is an ophthalmology eye problem as well.
In February, we had the Pseudomonas outbreaks from artificial tears. And just this month, in October 2023, we have the FDA telling us about other artificial tears, over 20 different brands, that might be a risk for eye infection. And on top of that, also in October 2023, a publication of what's becoming more and more popular, bilateral simultaneous cataract surgery, believe it or not, three patients, six eyes, bilateral endophthalmitis. And four out of those six were caused by staph, coagulase negative staph epidermidis, which was resistant to moxi and some of the other antibiotics that we typically use.
So what has ARMOR shown us? Well, the staph infections, almost 40% of them, depending on what year you look at, are resistant to methicillin. And what's equally important, if they're resistant to methicillin, they may be multidrug resistant. In fact, over three quarters of them, those have had a methicillin-resistant are also resistant to other antibiotics, three or more other antibiotics tested. That makes it kind of difficult to pick your correct antibiotic to be used. Of course, you're gonna get a culture and eventually that'll give you information on what to do. But you've got to get started right away. And that's where ARMOR can help when you can't wait. You can take a look at the ARMOR studies. We've seen over this period of time for the staph infections, that vancomycin has been really good, whether it's methicillin resistant or not. An interesting one of the commercial preparations, besifloxacin, has also been very good over this long time period.
Well, there is some good news here. Resistace trends have decreased over time. We're not down to anything real low, but they are decreasing. But you know, it's a little bit like blood pressure. We don't take it once and say it's normal and never look at it again. Surveillance studies give us trends over time, help us stay above the curve, stay on top of the curve and offer the best treatment to patients, public health advice and even research information. So take a look at ARMOR, the information is public, and it hopefully will help you get started treating your patients when time can't wait.
What To Know About MRSA Screening
MRSA screening is a low risk procedure used to determine whether you have MRSA on your skin or a MRSA infection. Antibiotic treatments are available if you test positive.
Every year, more than 35,000 people in the United States die of an infection from antibiotic-resistant bacteria. Methicillin-resistant Staphylococcus aureus (MRSA) is one type of bacteria that has contributed to this number.
MRSA is a type of Staphylococcus aureus (staph) bacteria that is resistant to many of the normal antibiotics used to treat staph infections. To prevent serious health complications, it's important that people with a MRSA infection begin proper treatment as quickly as possible.
MRSA screening allows doctors to quickly detect and begin appropriate treatment for those with MRSA infections.
MRSA screening is the diagnostic testing doctors use to determine whether MRSA is present on or in a person's body. It's also known as MRSA testing.
MRSA screening can be used to see if you have a MRSA infection and whether treatments are working.
Many people have MRSA or staph on their skin. MRSA can be spread through close personal contact and shared personal items like razors and towels.
A serious infection will only occur if MRSA enters inside the body and spreads. If you have a break in your skin or a weakened immune system, you're at a greater risk for a MRSA infection.
While MRSA infections used to occur mostly among people in hospitals, they're becoming more common among people outside of them. If you think you may have MRSA, you should be tested.
Symptoms of MRSASigns of MRSA can include an area of skin that is:
If a MRSA infection has spread to other parts of the body, you may also experience:
Some people confuse a MRSA infection with a spider bite. Even if you're not showing signs of an infection, your doctor may recommend you be screened for MRSA if you're having surgery and are susceptible to an infection.
No special preparation is required for a MRSA test, and there's very little risk associated with it.
Doctors can test for MRSA by taking samples from:
To collect a sample from an open wound, your doctor will use a special swab on the wound. Similarly, for a nasal sample, your doctor will twirl a special swab inside each nostril.
Alternatively, a blood draw from the arm can be used for a blood sample. A urine cup can also be used to collect urine.
You may feel some discomfort if a wound or your nose is swabbed, but this should be mild and short-lived. Similarly, pain or bruising may occur if a needle is inserted for a blood sample, but this should be temporary.
If you receive a positive MRSA test result, you have MRSA on or in your body. In the hospital, those with a positive MRSA test result may be sequestered or have additional protective protocols.
If you have a positive test result and are showing signs of infection, it's important to start treatment quickly.
Mild cases of MRSA may be treated with an oral tablet antibiotic, but for more serious infections, you'll likely need an intravenous (IV) antibiotic in the hospital. Antibiotics may be required for a few days or months depending on the extent of the infection.
In some cases, surgical procedures are necessary to treat complications like abscesses.
MRSA infections are potentially life threatening. It's important to get tested if you're experiencing symptoms of MRSA, such as skin that is painful, swollen, and warm to the touch.
MRSA screening is low risk, and testing samples can be collected through swabs, blood draws, or urine. Antibiotic treatments are available for those whose results come back positive.
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