Carriage and infection: what's the difference?
Staphylococcus can be found in the nose, skin and throat of many completely healthy people. Such carriage is not accompanied by complaints, is not contagious in the usual sense and is not treated with antibiotics: an attempt to “remove” the bacterium only leads to the growth of resistant strains. The doctor is not interested in the fact of the finding in the smear, but in the presence of inflammation: abscess, redness, fever. An exception is the targeted sanitation of the carrier before certain operations or with recurring boils, and the decision about this is made by the doctor.
- Carriage in the nose, skin and throat is common
- An asymptomatic finding on a smear does not require treatment
- They treat the disease, not the test result
- Sanitation is discussed before operations and in case of relapses
- Unregulated antibiotics increase resistance
What diseases does staphylococcus cause?
Most often these are infections of the skin and soft tissues: folliculitis, furuncle, carbuncle, abscess, infected wounds and burns, felon. Mastitis is possible in nursing women, and impetigo and bullous skin lesions in children. More severe forms develop when the bacterium enters the blood: osteomyelitis, purulent arthritis, pneumonia, endocarditis, sepsis. Separately, there is food poisoning with staphylococcal toxin, which begins a few hours after eating with violent vomiting and goes away within a day.
- Furuncle, carbuncle, abscess
- Impetigo and other skin infections in children
- Infected wounds and burns
- Mastitis in nursing
- Osteomyelitis and purulent arthritis
- Pneumonia and endocarditis
- Food poisoning toxin
- Sepsis
Who's at risk
The risk increases wherever the skin barrier is compromised or the body's defenses are weakened. These are cuts and abrasions, eczema and atopic dermatitis, postoperative wounds, places where catheters and prostheses are installed. Diabetes mellitus impairs healing and blood supply to the skin, so infections are more severe in these patients. Hospital strains are often resistant to common antibiotics, which makes treatment more difficult and requires culture and sensitivity testing.
- Damage and chronic skin diseases
- Diabetes mellitus
- Intravenous catheters and implants
- Recent surgeries and hospitalizations
- Immunodeficiency and use of immunosuppressants
- Contact sports and shared towels
- Chronic renal failure on dialysis
Diagnostics
The main method is culture of material from the lesion and determination of sensitivity to antibiotics. The material is wound discharge, pus from an abscess, sputum, urine or blood, depending on the location. It is important to take a culture before starting antibiotics, otherwise the result will be uninformative. A complete blood count and C-reactive protein show the severity of inflammation, while procalcitonin helps assess the likelihood of a severe bacterial infection. If damage to internal organs is suspected, an ultrasound, x-ray or echocardiography is prescribed.
- Culture of discharge with antibiogram
- Blood cultures for fever and suspected sepsis
- General blood test
- C-reactive protein
- Procalcitonin for severe infection
- Ultrasound of soft tissues to look for an abscess
- Echocardiography for suspected endocarditis
Treatment and prevention
With an abscess, the main thing is not the antibiotic, but its opening and drainage, which is performed by the surgeon. Squeezing out a boil yourself is dangerous, especially on the face: the infection can spread to the venous system of the head. Antibiotics are prescribed for widespread inflammation, fever, localization on the face, in patients with diabetes and immunodeficiency, selecting the drug taking into account the culture. The course must be completed. For prevention, treatment of minor wounds, personal towels and shaving accessories, and blood sugar control are important.
- Opening and draining an abscess by a surgeon
- Never squeeze out boils yourself
- Local antiseptic treatment and dressings
- Antibiotics as prescribed by the doctor and taking into account culture
- Full course without early cancellation
- Treating minor cuts and abrasions
- Personal towels, razors, washcloths
- Controlling blood sugar in diabetes