Staphylococcus Aureus Infection Follow-up

  • Author: Robert W Tolan Jr, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Jan 10, 2012
 

Further Outpatient Care

Appropriately monitor renal function, CBC count, and serum hepatic transaminase levels while patients with Staphylococcus aureus infection are undergoing therapy.

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Deterrence/Prevention

A large study in adult inpatients has demonstrated that universal surveillance, appropriate use of contact precautions and hand hygiene, and institutional culture change can decrease infections with MRSA.[103] Another approach likely to be cost-saving and to decrease infection in the intensive care unit is targeted screening and nasal decolonization,[104] although the benefits of nasal decolonization outside this setting remain undefined.[105] Prevention of transmission of MRSA among hospitalized children is a significant priority.[106]

Various vaccine candidates are being evaluated.[107, 108]

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Complications

S aureus infection may result in pneumonia, bone and joint infection, and infection of the heart valves.

In immunocompromised hosts (eg, patients with cancer who are neutropenic and have a central venous line), 20-30% develop serious complications or fatal sepsis following catheter-related S aureus bacteremia.

Community-associated methicillin-resistant S aureus (CA-MRSA) infection is more serious and is associated with thrombogenesis. It is becoming endemic in many pediatric and neonatal intensive care units.[109, 110, 111, 112]

Multiple brain abscesses have been reported in premature infants.[113]

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Prognosis

Morbidity and mortality associated with staphylococcal bacteremia in children seem to be less significant than observed in bacteremic adults.[114]

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Patient Education

Parents of infected children may require additional information/education.[115] For patient education resources, see the Women's Health Center and Skin, Hair, and Nails Center, as well as Toxic Shock Syndrome and Boils.

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Contributor Information and Disclosures
Author

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Coauthor(s)

Elizabeth P Baorto, MD, MPH  Director, Division of Pediatric Infectious Diseases, Atlantic Health System

Disclosure: Nothing to disclose.

David Baorto, MD, PhD  Medical Knowledge Engineer, Department of Medical Informatics, Columbia University Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

José Rafael Romero, MD  Director of Pediatric Infectious Diseases Fellowship Program, Associate Professor, Department of Pediatrics, Combined Division of Pediatric Infectious Diseases, Creighton University/University of Nebraska Medical Center

José Rafael Romero, MD is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, New York Academy of Sciences, and Pediatric Infectious Diseases Society

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD  Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Daniel Rauch, MD, FAAP  Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine

Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine

Disclosure: Baxter Honoraria Consulting

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

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Posteroanterior chest radiograph of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, revealing borderline cardiomegaly, multiple nodular infiltrates, and bilateral pleural effusions.
Lateral chest radiograph of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, revealing borderline cardiomegaly, multiple nodular infiltrates, and bilateral pleural effusions.
CT scan of the thorax (mediastinal windows) of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, revealing bilateral pleural effusions.
CT scan of the thorax (lung windows) of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, demonstrating multiple nodular infiltrates (some with cavitation) consistent with septic emboli, volume loss on the right, and pleural effusions.
CT scan of the thorax (lung windows) of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, revealing multiple nodular infiltrates (some with cavitation) consistent with septic emboli, volume loss on the right, and pleural effusions.
CT scan of the thorax (lung windows) of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, revealing multiple nodular infiltrates (some with cavitation) consistent with septic emboli, volume loss on the right, and pleural effusions.
CT scan of the thorax (lung windows) of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, revealing multiple nodular infiltrates (some with cavitation) consistent with septic emboli, volume loss on the right, and pleural effusions.
Follow-up CT scan of the thorax (lung windows) of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, revealing multiple nodular infiltrates (some with cavitation) consistent with septic emboli, volume loss on the right, and pleural effusions.
Follow-up CT scan of the thorax (lung windows) of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, revealing multiple nodular infiltrates (some with cavitation) consistent with septic emboli and evolution of the lesions over time.
Follow-up CT scan of the thorax (lung windows) of a 15-year-old with staphylococcal endocarditis and multiple septic emboli, revealing multiple nodular infiltrates (some with cavitation) consistent with septic emboli and evolution of the lesions over time.
 
 
 
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