Staphylococcal infection traps a child from the first minutes of his independent life in this world. Even in a maternity hospital, even with careful disinfection, staphylococci live and wait for their victim. In 95 - 97% of newborns, staphylococci are found in the first hours after birth. But not all children get sick from germs. About who and why is sick with staphylococcal infection and how to treat it, we will tell in this material.
What it is
Staphylococcal infection is the single name for a huge group of diseases that are caused by microbes - staphylococci. These microorganisms are capable of provoking a wide variety of pathologies - from pimples and pustules on the skin to severe bacterial pneumonia and sepsis.
For many parents, information that almost every newborn is infected in a maternity hospital, can be a real discovery. In fact, there is no reason to panic. Not every child has staphylococcus ailments, because babies are well protected from this microbe by innate maternal immunity. A person encounters this microbe throughout his life, and adults develop a strong immunity to staphylococci. During pregnancy, the baby receives ready-made antibodies from the mother.
The presence of staphylococcus on the mucous membranes, skin or in the feces of an infant is not an infection yet.
If the child's condition remains normal, then there are enough maternal antibodies to inhibit the activity of the microbe. The infection can develop in babies who were born as a result of a very difficult and problematic pregnancy. The risk group is as follows:
- premature and low birth weight children;
- children with congenital immunodeficiency conditions (for example, those infected with HIV);
- children whose mother, in the process of gestation, suffered from gestosis, lack of water or polyhydramnios;
- children with congenital malformations.
Congenital immunity "ends" by about six months, and from this age the child's own immunity begins to "learn" and develop its antibodies to microbes and the virus. It is at this time that outbreaks of staphylococcal infection are most often diagnosed in infants. The infection itself can be localized and diffuse, as well as acute and chronic. Here is just an approximate list of diseases that can be caused by staphylococci:
- pyoderma;
- felon;
- whitlow;
- boil or abscess;
- phlegmon;
- epidemic pemphigus of newborns;
- staphylococcal angina;
- otitis;
- conjunctivitis;
- pneumonia;
- ostriomyelitis;
- endocarditis;
- pyelonephritis;
- cystitis;
- omphalitis;
- enterocolitis;
- sepsis.
About the pathogen
Staphylococci under the microscope resemble bunches of grapes, and therefore they received this name - staphylos - grapes, coccus - grain. Each microbe has a spherical shape, together they are grouped into a bunch. These microbes are carried by 100% of the world's population.
Science today knows 27 types of staphylococcal bacteria. 24 of them are not dangerous for humans, they coexist peacefully with people. Only three types of bacteria are capable of causing disease, since they are opportunistic. This property explains why not every child gets sick - with normal immune defenses, bacteria do not harm a person, and begin to become pathologically activated only when there are prerequisites for this - the child is weak, the immune system does not cope, the child underwent surgery or instrumental manipulations, and so on.
You need to get to know these three types better.
Staphylococcus aureus
Behind the beautiful Latin "aureus" lies, as you might guess, Staphylococcus aureus. This is the most dangerous and aggressive microbe, which becomes the "culprit" of most staphylococcal infections. In total, it can cause more than a hundred different ailments.
Such a poetic name was given to him for his ability to form a golden pigment. This bacterium can infect both the skin and internal organs. Its main feature is the formation of pus. The microbe is stubborn and very tenacious - it is not afraid of boiling, frost, chlorine and hydrogen peroxide, it doesn’t care about alcohol and formalin, salt and acids, and it cannot be eliminated by exposure to direct sunlight.
The only remedy that can instantly destroy the structure of a microbe is the most ordinary "green stuff".
Methicillin-resistant Staphylococcus aureus is the most insidious of the species. He usually "lives" in medical institutions, where from constant disinfection and exposure to drugs becomes truly unkillable. It cannot be eliminated with most antibiotics - penicillins and cephalosporins. Diseases caused by such a "modified" microbe are very difficult to treat.
Staphylococcus epidermidis
Epidermal staphylococcus aureus chooses the skin and mucous membranes of a person for its life. It does not manifest itself in any way while the child's immunity is strong and looks completely harmless. But everything changes if the immune system is weakened.
From the skin and mucous membranes, the microbe quickly enters the body through wounds, places of surgical incisions and causes severe lesions, up to sepsis. For this behavior, this microbe was very disliked by surgeons, because it sometimes complicates the recovery period even after a successful operation.
Staphylococcus saprophyticus
Saprophytic staphylococcus aureus in babies is very rare. His favorite habitats are urogenital tract of women. If a pregnant woman suffers from such an infection, then the likelihood of infection at the time of delivery in the child increases. This microbe causes complicated cystitis and pyelonephritis.
Causes of diseases
The very breadth of distribution of staphylococci is the main reason for the development of infections. In any person, laboratory samples can detect this microbe and not one, but several varieties at once. Dangerous members of the species are spread in various ways:
- Airborne... Microbes are quickly and easily removed from the patient's body with exhaled air and can exist for a long time in it and in the dust, without at all losing their activity.
- Bytov... A baby can get a sample of a not very friendly microorganism through contact with the hands of parents, medical personnel, through tools, through objects that were held by infected people. Antiseptics and alcohol on staphylococcus aureus will not work.
- Food... A newborn and a nursing child can get staphylococcus with breast milk, with drinking water, with water in which the parents diluted the formula. Boiling will not help, because the microbe is not afraid of boiling. A breastfeeding infant who is injected with complementary foods can become infected after eating dairy and other foods that have been in contact with a person carrying the bacteria. Improper storage and insufficient heat treatment make contamination even more likely.
The internal causes that contribute to the development of infection after the ingress of bacteria are diverse, but, in fact, they boil down to one factor - insufficient immunity in general and local immunity in particular.
A child's body weakened by something, the presence of chronic or congenital diseases, prematurity - all this significantly reduces the ability of the child's body to resist. This is how staphylococcal infection begins to develop in one of its many manifestations.
The likelihood of infection increases significantly if the child is in contact with a person who has open wounds affected by staphylococcusif an adult has an acute or chronic bacterial respiratory infection.
Symptoms and Signs
The symptoms of staphylococcal infection are caused by the fact that microbes in the process of their vital activity secrete toxins and enzymes that can destroy neutrophils and macrophages, as well as lymphocyte cells. An abscess is usually formed at the site of entry of the microbe. The toxins spread throughout the body through the bloodstream, causing symptoms of severe intoxication.
Intoxication is manifested by an increase in body temperature, severe weakness. The baby's behavior changes - he begins to refuse to feed, his sleep is disturbed, and moody crying appears. The more severe the infection, the more pronounced the signs of intoxication will be:
- The most common manifestations of staphylococcal infection are cutaneous... Pustules and boils may appear on the skin of the face, hands, legs, tummy. The rash is always accompanied by a purulent process. Quite often, in newborns, the infection begins with a purulent inflammation of the umbilical wound.
- Omphalitis - the most common staphylococcal inflammation. The umbilical wound with it becomes inflamed due to infection with Staphylococcus aureus. It becomes painful, reddened, and pus is released with light pressure.
- The skin manifestation of infection is quite diverse - from solitary vesicles and pustules to extensive rash on the face and body... The blisters are filled with a cloudy liquid, bursting even from a light touch, a golden yellow crust forms in their place. If the skin is affected throughout the body, then we are talking about pemphigus - pemphigus of newborns.
- The bacterium can multiply not only on the skin and in the subcutaneous layer, it happens that it affects bones and joints. Purulent inflammation of the bones - osteomyelitis - manifested by pain in the limbs, which becomes worse with movement. At rest, the baby may not show strong anxiety, but during gymnastics or laying on his tummy, he begins to be capricious and cry piercingly. If the joint is affected, then the disease is called arthritis, manifested by swelling and redness of the joint, pain on palpation.
- If a staphylococcal infection affects the upper and lower respiratory tract, then the child develops characteristic symptoms of respiratory diseases - a runny nose, cough, fever. Leaks hard staphylococcal angina - with her, the baby cannot eat normally because of pain when swallowing. His tonsils are enlarged and inflamed, pustular formations are visible on them. Pustules can appear in the nose.
- Bacterial pharyngitis always accompanied by a dry, excruciating cough. All types of respiratory staphylococcal lesions are characterized by high fever.
- If a microbe in a baby causes inflammation of the lining of the heart — endocarditis, then this is manifested by high fever - up to 40.0 degrees and above, pain in the sternum, difficulty breathing. When listening, characteristic heart murmurs are noticeable.
- Intestinal manifestations bacterial infection make themselves felt with abdominal pain, bloating, increased flatulence. The baby's stool changes - painful frequent diarrhea can be observed, and vomiting is possible. The crumbs have no appetite, behavior and sleep are disturbed, he is capricious. At high temperatures, dehydration occurs very quickly.
- Brain damage (meningitis) manifested by severe weakness, fever, nausea. The baby becomes very lethargic, all his muscles are relaxed. Neurological disorders, seizures, and loss of consciousness may occur.
- If an infection develops in the urinary tract, then the baby shows great anxiety during urination. He screams loudly, bends. There may be an elevated body temperature. With staphylococcal sepsis, almost all internal organs and systems of the baby are affected.
Quite often, the microbe causes conjunctivitis in newborns. Inflammation of the organs of vision is purulent and, in the absence of timely medical assistance, can result in loss of vision. Whatever disease staphylococci cause, all ailments will have common signs that will allow the doctor and parents to suspect bacterial infection:
- heat;
- purulent lesions;
- severe intoxication.
Consequences and danger
Staphylococcal infection is a disease that in no case can be treated with folk remedies and grandmother's recipes. Not every strong antibiotic can kill a bacterium that has become aggressive; herbal decoctions in this case cannot help a child at all. To form a prognosis, it is important to know at what stage staphylococcus is detected. If this is an early infection, and several days have passed since the beginning of the infection, then the prognosis is more favorable.
Delay and improper treatment of bacterial inflammation of almost any organ are dangerous with the occurrence of systemic infection - sepsis.
Staphylococcal sepsis, according to medical statistics, leads to death in about 70% of cases. The mortality rate from endocarditis caused by staphylococci is 45-50%. Dangerous and infectious toxic shock and pulmonary edema, which are also often observed in infants with severe bacterial infection. The mortality rate from such conditions ranges from 25 to 40%.
Acute staphylococcal infection often enough, unfortunately, causes a chronic disease of the affected organ. So, a single staphylococcal angina can lead to chronic tonsillitis. The most unfavorable forecasts are given in relation to nosocomial infection, which the baby becomes infected in a medical institution. It is difficult to treat, the microbe is resistant to antibiotics, and it is these drugs that are practically the only way to help. So, nosocomial sepsis leads to death in about 90% of cases, and hospital pneumonia leads to the death of babies in 80% of cases of infection.
Light bacterial contamination practically does not exist. In most cases, they are complicated - angina can cause damage to the kidneys or the heart membrane, and furunculosis can cause the development of severe conjunctivitis and other forms of staphylococcal infection.
The mortality rate of newborns and infants from staphylococcal infections is increasing. Both the Ministry of Health and the World Health Organization had to admit this fact. This is due to the fact that adults themselves are uncontrollably treated with antibiotics even when they are not needed, for example, with flu or ARVI. Taking antibiotics for any reason and without it has gradually led to the fact that new strains of microbes are emerging faster than the pharmaceutical industry is developing drugs against them.
Diagnostics
If you suspect a bacterial infection and even just when the temperature rises to 39.0 degrees and above, as well as when a rash, pustules appear, parents must call a pediatrician or an ambulance. During the initial examination, the doctor will assess the general symptoms, if he detects high fever, purulent inflammation, as well as symptoms of intoxication, the doctor will definitely find out from the parents whether the baby has had contact with patients, whether he has undergone any procedures in hospital conditions.
If a severe bacterial infection is suspected, with high fever, vomiting, diarrhea, the child will be hospitalized.It is recommended to stay under the round-the-clock supervision of doctors in an infectious hospital for all babies with staphylococcal infection who are under one year old.
They can leave the child at home only if he has minor skin rashes, a localized form and does not have a high temperature.
The main diagnostics are carried out in the laboratory. For respiratory manifestations, for example, with sore throat, a swab is taken from the throat, for pustular lesions, a sample of the contents of the blisters or boils, as well as a blood test. If you suspect sepsis or bacterial damage to internal organs, a blood test.
The study is called bacterial culture. The collected sample is plated on a nutrient medium and wait until a bacterial colony grows. Microscopic examination shows which bacteria have grown. This makes it possible to confirm or deny staphylococcal infection.
In order to understand how to deal with this, the laboratory assistant of the grown microbes is exposed to the most common antibiotics. The drug to which the microbes show sensitivity becomes the basis for the treatment of this child.
Depending on the symptoms, the search for bacteria is conducted in blood samples, urine samples, in the feces of an infant, as well as in his mother's breast milk.
As already mentioned, if you wish, you can find staphylococci in any person using laboratory methods, and therefore the detection of these microbes is not considered a disease in itself. There are norms that correspond to completely healthy conditions. In case of illness, these norms are significantly exceeded:
- The rate of content of Staphylococcus aureus in a nasal smear is 10 to 2 degrees or 10 to 3 degrees.
- The normal microbe content in a throat swab is 10 to 4 degrees.
- In the intestines, in the blood, there should be no staphylococcus normally.
Tests are done for more than one day, but this should not scare the parents. Throughout the time it takes laboratory technicians to figure out the whole picture, the child will receive treatment, he will not be left without attention. Until the exact pathogen is known, the doctor may prescribe broad-spectrum antibiotics or provide symptomatic treatment. For an accurate diagnosis of the infection, the advice of other specialists is sometimes required - gastroenterologist, surgeon, neurologist, dermatologist, hematologist, otolaryngologist.
Treatment
Treatment of staphylococcal infection includes two main areas:
- suppression of bacterial activity, elimination of pathogenic microflora;
- activation of the child's immunity.
Depending on the severity and nature of the specific disease caused by the microbes, can be shown:
- conservative treatment;
- surgical intervention.
Medication treatment
The basis of therapy for any form of staphylococcal infection is antibacterial drugs. Babies are usually prescribed antibiotics of the penicillin group. Given the resistance of many microbes to penicillin, semi-synthetic penicillins, for example "Ampicillin". Penicillins with clavulanic acid - "Amoxiclav", have proven themselves well in the fight against staphylococci.
Antibiotics-aminoglycosides are very effective against staphylococcus. However, parents should be aware that drugs such as "Gentamicin", "Neomycin" are ototoxic.
In other words, their use in childhood often leads to partial hearing loss or complete deafness. Therefore, it is better to refuse such funds if there is no vital necessity. In fact, there can be only one need - severe sepsis, in which "Gentamicin" can save a child's life, even at the cost of hearing loss.
Antibiotics of the cephalosporin group and macrolides for staphylococcus are prescribed, but not as often as penicillins. Basically, these drugs are resorted to in the event that the child does not have relief after taking penicillin drugs, as well as in the case of a nosocomial infection.
Treatment with antibacterial drugs should take place according to certain rules:
- the specific drug is chosen by the doctor;
- the course of treatment is prescribed by the doctor, and it is strictly forbidden to change it up or down;
- you should not use two antibiotics at the same time;
- antibiotics are prescribed to infants together with drugs that protect and restore the intestinal flora in order to avoid dysbiosis - "Bifidumbacterin", for example.
Unfortunately, there is no alternative to antibiotics for severe infections. But in mild and moderate forms, they can be prescribed staphylococcal bacteriophages... A bacteriophage is a virus that consumes a disease-causing bacterium. Sometimes these drugs are given in conjunction with antibiotics.
Bacteriophages are used externally in the form of compresses and lotions, for treating wounds, as well as inside - with internal inflammatory processes. They drip into the nose with rhinitis, into the ears - with purulent otitis media, they irrigate the baby's throat with staphylococcal infection. Only in Russia can a doctor prescribe a bacteriophage to a child separately from an antibiotic. Nowhere in the world are bacteriophages treated as an independent method of treating bacterial infection. In world practice, they are usually prescribed in combination with antibiotics.
If necessary, in stationary conditions, the child will be prescribed treatment that increases immunity. These can be immunomodulatory drugs. But their appointment is not a mandatory practice, but rather the personal opinion of a particular doctor. There is still heated debate about the advisability of using immunomodulators in early childhood. If the decision to use such drugs is made, then the child can be injected with antistaphylococcal plasma or immunoglobulins.
This is where the main therapeutic program ends and additional, but no less important, symptomatic treatment begins:
- With enterocolitis or gastroenteritis - "Enterofuril", drinking plenty of water, "Regidron" or "Smecta" to replenish the water-salt balance, which is disturbed by vomiting and diarrhea. During the illness, the diet does not change if the child is fed naturally. For babies who eat adapted formulas, it is recommended to slightly lower the concentration of the formulas, adding a little less dry matter than necessary - this will reduce the load on the digestive organs.
- For any skin manifestations - local treatments with antiseptics and antibiotic solutions. The umbilical wound, bursting blisters can be treated with hydrogen peroxide. In the opinion of parents, the drug "Chlorophyllipt" gives good results. It is absolutely impossible to use any alcohol-containing liquids for a newborn and an infant.
- For respiratory injuries drops with antibiotics in the nose (in the ear) are shown, as well as the aspiration of the nasal passages of the baby using an aspirator, since the accumulations of nasal mucus in the crumbs that still cannot blow their nose are a fertile environment for the development of new colonies of staphylococcus. Additionally, vasoconstrictor nasal drops and Chlorophyllipt may be prescribed.
- Staphylococcal sore throat will require parents to carry out procedures for irrigation of the throat and tonsils with the antiseptic Miramistin, Chlorophyllipt, and lubrication with Vinilin balm.
Surgical measures
Surgical treatment of staphylococcal infection is required when the baby has deep boils, phlegmon, abscesses. In addition, surgical intervention may be required for purulent sore throat, lung abscess and pustular lesions of other internal organs.
The essence of the intervention is in instrumental dissection of purulent formation and thorough cleaning of the cavity from pus, necrotic altered tissues. At the same time, the contents of the abscess are sent to the laboratory for analysis, and the child is prescribed local treatments with antiseptics, dressings, topical bacteriophages, and antibiotics - systemically (inside).
Since Staphylococcus aureus is afraid of "brilliant green", it is often recommended to treat the wound after surgery with this solution.
General recommendations for treatment
You cannot walk with a child at high temperatures, bathing should also be postponed. After the fever subsides (usually 2-3 days after starting antibiotic use), you can walk and swim. It should be remembered that a child with an acute staphylococcal infection is contagious to others, therefore, it is important to limit his contact with other children or pregnant women who live with a sick baby.
The baby's nutrition (this applies to babies who have already switched to complementary foods) should be light, especially carefully should be approached to the diet with intestinal damage. Diet and drinking regimen will be advised by the attending physician, depending on the specific diagnosis.
The acute period of infection is always very dangerous, since the baby has a high risk of developing febrile seizures and dehydration against a background of high fever and intoxication.
A plentiful drinking regime will help reduce the risks. The baby needs to be watered often, the water should be warm, but not hot. If the temperature of the liquid is equal to the body temperature of the sick crumbs, then the absorption of the liquid proceeds much faster.
Prevention
The spread of staphylococcal infection directly depends on how quickly new facts of diseases are revealed and how correctly and promptly the doctors begin treatment. For this reason, you should not carry a child with suspected staphylococcus aureus to the clinic for a doctor's examination. Other children who will sit with you in the same line are not to blame for anything and should not be infected. It is more expedient to call a doctor at home.
The baby should have his own towels, bed linen, toys. Sharing hygiene items by two or more children is unacceptable. If in the family someone has signs of a purulent disease, contacts with the baby from this person should be temporarily stopped. If the mother has cracks on her nipples, it is worth taking prompt measures to eliminate them, because staphylococcus is very often transmitted to the baby with breast milk precisely because of cracks in the nipples.
It is a great parental mistake to give your child your own choice of antibiotics for every sneeze. This increases the risks of bacterial complications tenfold. The medical staff of all medical institutions, especially maternity hospitals and children's hospitals, should be regularly tested for asymptomatic carriage of staphylococci.
It's important to understand that there is no one-size-fits-all way to keep germs out of your child. This is impossible, a person lives his whole life next to staphylococci. In such conditions, the child's immunity plays a role, only he is able to make sure that no staphylococcus is dangerous.
Therefore, the advice to temper the baby from the very first weeks of his life, feed correctly and walk a lot is not an empty phrase, but the best ways to make sure that the family can only read about staphylococcal infection without encountering it personally.
About what staphylococcus aureus is in children and how to treat it, see the next video.
