Staph Aureus

Question 1

What is the spectrum of staph aureus infections and the source of bacteraemia?

Answer 1

Skin and soft tissue infections
Localised pyogenic staphylococcal infections
Deep seated abscesses, necrotising fasciitis, pyomyositis
Osteomyelitis, septic arthritis, discitis
Infective endocarditis
Pneumonia, empyema
Wound infection and vascular line or catheter related infection

Source of infection usually from colonisation of sites by sa

Question 2

How is S Aureus bacteraemia investigated?

Answer 2

Microscopy and culture of specimens
Multiple blood cultures before commencing antibiotic therapy
Repeat blood cultures 72 hours after starting therapy
Biopsy samples may be of value for bone infections
Imaging: X-ray, ct, mri, radionuclide imaging, transthoracic echocardiography, TOE

Question 3

How is S Aureus bacteraemia managed?

Answer 3

Antibiotic therapy
Source identification and clearance + appropriate surgical intervention

Uncomplicated: flucloxacillin 14d
Others: vancomycin, teicoplanin, linezolid, daptomycin