Staphylococcinum (Staphycoc) = Staphylokokkeneiter/= sterilisierte Bakterienkultur von Staphylococcus epidermis
After-effects of Common Infection
The staphylococcus bacterium thrives in circumstances of debility from overwork, anxiety, poor nutrition, constitutional weakness. Affinity for the endocardium.Staphylococcal is the chief
bacterial factor in acne, abscess, furuncle; empyema, endocarditis. Micro-organism responsible for producing a superficial cellulitis, in association with an open wound (Beers and Berkow, 1999).
S. aureus, which is present in the nose and on the skin of a variable proportion of healthy people, is an opportunistic pathogen in that it causes infections most commonly at sites of lowered host
resistance e.g. damaged skin or mucous membranes. The common infections caused by S. aureus are skin and wound infections, abscesses, osteomyelitis and food poisoning.
Staphylococcus aureus sensitive to many antimicrobial agents but some strains produce the enzyme β-lactamase which inactivates the action of β-lactam antibiotics. These are called
multi-resistant strains of S. aureus (MRSA).
S. aureus is the commonest cause of both social and community acquired infections. Patient to patient transmission via the hands of the personnel are the most common and prevalent
means of spread (Berkow et al., 1992).
S. aureus are facultative anaerobes that are able to grow on any nutrient media. Due to the fact that it does have some haemolysins, certain strains can cause β-haemolysis on blood agar plates.
It does not grow on MacConkey agar with crystal violet.
Toxins and enzymes
S. aureus is the primary toxin-producing type of staphylococci and produces a wide range of extracellular products viz. haemolysins, leukocidin, enterotoxins, exfoliatinand enzymes (Howard et al., 1995).
S. aureus produces four types of haemolysinsviz. alpha, beta, gamma and delta. The exact role of each type of haemolysin is not known but it is believed that alpha haemolysins have
dermonecrotic activity as well as haemolytic abilities (Howard et al., 1995).
Leukocidin toxin is capable of causing lysis of human leucocytes and macrophages.
If these toxins are produced the patient will develop an impaired immune system. The leucocytes are a major part of the human immune system. This will expose the patient to infections
(Iwase et al., 1990)
There are five types of enterotoxins (labelled as A through to E) produced by S. aureus. These toxins are responsible for staphylococcal food poisoning and conditions such as toxic
shock syndrome which results when staphylococci grow and thrive within a cavity on the human body (Howard et al., 1995).
Exfoliatin is a toxin which has an epidermolytic or exfoliative effect. It causes layers within the epidermis of the skin to split thereby causing exfoliation of the skin (Ladhani et al.., 1999).
There are numerous enzymes produced by staphylococci viz. lipase, fibrinolysins and proteases. However, S. aureusproduces the enzyme coagulase which not only causes haemolysis but also inhibits the bactericidal activity of the normal serum. (Howard et al., 1995)
S. aureus constitutes the largest amount of Staphylococcal infections due to coagulase enzyme production. Local infections are by far the most common of all types of staphylococcal
infection. More serious invasive staphylococcal infections are not very common in healthy individuals, but may occur in immunocompromised patients. Predisposing factors include injury to
normal skin, prior viral infections, leucocyte defects, deficiencies in humoral immunity and alteration of normal flora due to use of antimicrobial agents to which S. aureus is not susceptible.
This organism may also invade the blood stream and from the re spread to numerous body sites (Howard et al., 1995).
Pathogenic staphylococci are ubiquitous; they are carried in the anterior nares of about 30% of healthy adults and on the skin of about 20%. Newborns and nursing mothers are predisposed to staphylococcal infections, as are patients with influenza, chronic bronchopulmonary disorders (e.g. cystic fibrosis, pulmonary emphysema), leukaemia, neoplasms, transplants, prostheses or other
foreign bodies, surgical incisions, diabetes melJitus, and indwelling catheters. Patients receiving adrenal steroids, irradiation, immunosuppressants, or antitumor chemotherapy are also at risk.
(Beers et al., 1999:1147.)
[Khanya Zukolwakhe Bisholo]
is a type of bacterium
opening of the body surface such as
the skin, hair
people and animals
belongs to the family Staphylococcaceae
least 30 species have been recognised by biochemical analysis
is a strain that
been considered a
nosocomial pathogen. M
of MRSA have been
increasing and were found in patients who were associated with pig farms
The incidence of
is also associated with ethnicity.
In the US
, the incidence of invasive MRSA in the black population (
% per year)
le that in the white population
% per year) (Tong
365 episodes of
mia identified in Cape
Town, with an annual incidence of 3.28 cases per 1
000 hospital admissions (Naidoo
when a food handler
contaminates food which is not properly stored. Unsanitary conditions and crowded
community settings increase exposure to
The bacteria can
be transmitted from person to person through contact with a carrier.
by a short incubation period of 1 to 6 hours. The onset is sudden and is characterized
by vomiting and diarrhoea but no fever (Foodsafety.gov, 2015).
treatments for these patients are rest, plenty of fluids and medicine to calm
[Jonathan Reuben/Rai Invernizzi]
2.4.3 STAPHylococcus AUREUS
Staphylococcus aureus tails under the family Staphylococcacea and genus Staphylococcus, which comprises of at least 20 different species of which Staph. al/reus together with Staphylococcus epidermidis, and Staphylococcus saprophyticus, are recognised as being the most medically significant (Mims, et aI., 1998:513).
18.104.22.168 Morphology and identification
Staphylococcus aureus are spherical organisms, usually about one micrometer in diameter, and occur in irregularly shaped clusters. They may also be seen singularly, in pairs, tetrads or chains.
Younger cells stain Gram-positive, however older cells may stain Gramnegative. (Jawetz, el aI., 1991: 194.) Staph. auretts are non-motile, non-sporing and generally non-capsulate. When grown
on laboratory media, colonies are generally circular, 2-3 mm in diameter, and have a-smooth, shiny surface. Colonies are opaque, and may have a golden-yellow, fawn or cream colour to them. (Greenwood, Slack and Peutherer, 1992:204.) When grown anaerobically, colonies are notably smaller, and more greyish in colour (Jawetz, el al., 1991: 194). The optimum growth temperature
is 37° C, although pigment is formed best at 20 - 25° C (Mackie and McCartney, 1996:246).
Staphylococcus aureus occurs as part of the normal flora of the skin, and is present in the nasal cavities of 40 - 50% of healthy human beings (Jawetz, et al., 1991: 196).
22.214.171.124 Staphylococcus aureus infections
Staphylococcus aureus is by far the most clinically important Staphylococcal pathogen (Mackie and McCartney, 1996:248). Most strains are incapable of penetrating the normal barrier function of the skin, and tend only to cause infection when penetrating through breaks in the skin. Localised infections may progress to bacteraemia, whilst spontaneous' bacteraemias have been noted, where there
is no origin of sepsis evident. This occurs more often in chronically debilitated patients. (Mackie and McCartney, 1996:248.)
Once past the barrier of the skin, Staphylococcus aureus strains possess a large number of cellassociated and extracellular factors, which often enable the organism to survive the bodies defences and colonise the tissue. It is thought that these factors acting in unison make it possible for the organism to bind to connective tissue, resist the bactericidal response of the complement system, and prevent uptake by phagocytes.
Staphylococcus aureus may cause: Pyogenic infections such as: carbuncles, boils, breast abscess, lung abscess, and empyema;
o Disseminated infections such as septicaemia; & Toxin-mediated illness, such as toxic shock syndrome and staphylococcal food poisoning. (Greenwood, Slack and Peutherer, 1992:204.)
Pathological changes caused by Staph. al/reus, are usually due to enzymes and toxins produced by the bacteria. These include:
o Coagulase, an enzyme that both clots plasma and inhibits the uptake and phagocytosis of the bacteria by macrophages; Cl) Leucocidin, which kills white cells;
e Lytic exotoxins, which destroy red blood cells and platelets;
o Deoxyribonuclease, which destroys deoxyribonucleic acid;
o Lipase, which aids in the breakdown of fats;
e Staphylokinase, which causes fibrinolysis;
Cl) Exfoliatin, which causes the peeling of the skin;
o Enterotoxin B, which causes food poisoning;
o Beta-lactamases that lead to penicillin-resistance.(Greenwood, Slack and Peutherer, (1992:205.)
126.96.36.199 Anti-microbial sensitivity
Staph. aureus is resistant to most broad-spectrum penicillin such as ampycillin and amoxycillin due to the production of beta-lactamases by the bacterium. Clavulanic acid inactivates beta-Iactamase, and sometimes is used in conjunction with amoxicillin (co-amoxiclav) as a therapy. Certain strains resistant to other antibiotics such as tetracycline or erythromycin, and even beta-lactamase-resistant penicillin, are not uncommon. All Staphylococcus aureus strains remain susceptible to the glycopeptides antibiotics, vancomycin and teicoplanin. (Mackie and McCartney, 1996:247-248.)
Gemüt: Auf-/Zusammenfahren (erwachend)
Furcht (in engen Räumen)
Gedächtnisschwäche (für das, was geschrieben hat)/vergesslich (vergisst, wohin sie geht)
Konzentration gut, aktiv
Reizbar, gereizt/verbittert, verärgert
Verwirrt geistig (im Freien)
Weinen (aus Verzweiflung/um Zukunft)
Kopf: Abszess in Gehirn
Schmerz [nachmittags - 16 h/gegen Mitternacht/im Hinterkopf (um Mitternacht/dumpf/pulsierend)/in r. Schläfe (pulsierend)/r. erstr. l. (drückend)/in l. Schläfe (ziehend)/seitlich (lanzinierend)/in Stirn r./in Stirn über/hinter den Augen l.]
Schweregefühl in Stirn
Auge: Hautausschläge um die Augen
Schmerz in Lider (wund schmerzend)
Gerstenkörner (an Lider)
Zysten der Meibomsche Drüsen
Zuckende Lider - r.
Ohr: Absonderung wässrig
Geräusche im Ohr, Ohrgeräusche wenige
Nase: Absonderung - dünn/klar/aus Choanen
Schnupfen morgens erwachend
Niesen morgens erwachend/+ trockener Nase
Verstopfung + Schnupfen/< im Schlaf
Gesicht: Aufgesprungene Lippen
Hautausschläge - Bart - Follikulitis/Lippen/Nasenmuschel vorne innerlich
Schmerz (prickelnd, kribbelnd)
Mund: Hautausschläge - Zunge
Schmerz (Zunge/wund schmerzend)
Geschmack - sauer nachts
Innerer Hals: Schleim gelb
Äußerer Hals: Schmerz (wund schmerzend)
Geschwollene Halsdrüsen Magen: Durst
Leeregefühl nicht > durch Essen
Übel < nach Essen
Hautausschläge - juckend/rot/um Nabel
Schmerz - vor/während Durchfall/krampfartig/in Hypogastrium/r./lanzinierend
Rektum: Durchfall (morgens/< nach Essen)
Flatus (vor/beim Stuhlgang)
Stuhldrang bei Durchfall
Stuhl: Dunkel/häufig/lang, schmal/wässrig
Gewaltsam, plötzlich, in einem Schwall
Blase: Harndrang vergeblich
Urin: Sediment eitrig
Weibliche Genitalien: Menses lange sich hinziehend
Atmung: Behindert, gehemmt mit Zusammenschnürung der Brust
Brust: Abszess in Lungen
Entzündung im Endokard + Perikarditis - rheumatisch/im Perikard/in Lungen durch Staphylokokken
Hautausschläge - flüchtiges Exanthem - rot
Herzbeschwerden - Myokard
Schmerz - Finger (schneidend)/Handgelenke (Wehtun)/Oberschenkel < Bewegung (Wehtun)/Schultern (Wehtun)
Steifheit in Ellbogen/r. Schulter
Zittern in Hände
Zusammenschnürung in OberarmeRücken: Entzündung in Rückenmark/in Wirbel
Schmerz (in Sakralregion/wund schmerzend/in Steißbein)
Schlaf: Einschlafen früh
Erwacht zu früh/plötzlich
Träume: Kämpfe/merkwürdig, wunderlich/Wanzen
Fieber: mit Frost
Veränderliche, wechselnde Anfälle
Haut: Hautausschläge - Bläschen
Bläschen - Purpura
Allgemeines: Entzündung der Knochen (des Knochenmarks)
übermäßige, körperliche Reizbarkeit
Speisen und Getränke: Verlangt: Erdnussbutter/Gewürze, Würzmittel/Süßigkeiten;
Komplementär: Ars. Hep. Nat-m. Sil. Sulph.
Unverträglich: Potenz unter C 500
Antidotiert von: Mag-f. Rheum.