Staphylococcus aureus

S. aureus is the most common

cause of pyogenic infection of
the skin and soft tissue.
It causes impetigo, furnucles
(boils), cellulitis, abscess,
lymphadenitis, paronychia,
omphalitis, and wound
infection.
S. aureuscan also cause
serious infections such
Bacteremia, pneumonia, or
bone and joint infections.
Nelson Textbook of Pediatrics 19th
Edition

Etiology
Disease may result from tissue invasion or
injury caused by various toxins and
enzymes produced by the organism
Strains of S. aureus can be identified by
the virulence factors they produce and can
be classified by various molecular
techniques..

Nelson Textbook of Pediatrics 19th

Edition

Epidemiology
Many neonates are colonized within the first week of
life
20-40% of normal individuals carry at least 1 strain
of S. aureus in the anterior nares at any given time
The organism may be transmitted from the nose to
the skin, where colonization seems to be more
transient
Umbilical, vaginal, and perianal are other potential
sites of colonization
Because staphylococci are found on the skin and in
the nasopharynx, bacteria is common and is
responsible for many nosocomial infections.
Nelson Textbook of Pediatrics 19th
Edition

Pathogenesis
The intact skin of the mucous
membranes serve as barriers to
invasion by the staphylococci

Defects in the mucocutaneous barriers

produced by trauma, surgery, foreign
surfaces and burns increase the risk for
infection

At these sites, they evade defense

mechanisms of the host, colonize in
tissues & form abscesses, produce
extracellular enzymes and exotoxins
Nelson Textbook of Pediatrics 19th
Edition

Staphylococcus
aureus

Multiple strains

Toxinproducing
strains

Localizing
strains
Coagulase
Clumping
factor
Protein A
Bacteremia

Focal infection

Disseminated
infection

Boil
Absces
s
Sinusiti
s

TSST-1

Toxic shock
syndrome

Enterotoxi
n

Food poisoning

Nelson Textbook of Pediatrics 19th

Edition

Exfoliatio
n

Scalded skin
syndrome

Parenteral antimicrobial agent(s) for treatment of

Bacteremia and other serious Staphylococcus aureus
infections
SUSCEPTIBILITY

ANTIMICROBIAL AGENTS

COMMENTS

INITIAL EMPIRIC THERAPY (ORGANISM OF UNKNOWN SUSCEPTIBILITY)

Drugs of
choice:

Vancomycin
gentamicin or rifampin

For life-threatening infections(i.e., septicemia,

endocarditis, CNS infection); linezolid could be
substituted if the partner has received several
recent courses of vancomycin

Nafcillin or oxacillin

For non life-threatening infection without signs of

sepsis (e.g., skin infection, cellulitis,
osteomyelitis, pyarthrosis) when rates of MRSA
colonization and infection in the community are
low

Clindamycin

For non life-threatening infection without signs of

sepsis when rates of MRSA colonization and
infection in the community are substantial and
prevalence of clindamycin resistance is low

Vancomycin

For non life-threatening, hospital acquired

infections

Nelson Textbook of Pediatrics 19th

Edition