This essay is concerned with staphylococcal infections, in particular those caused by staphylococcus aureus, focusing in particular on urinary tract infections. Included are descriptions of the bacteria, risk factors, treatment and avoidance and control. …
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Also mentioned are the newer, drug resistant strains and the global implications of these. Introduction The bacteria of staphylococcus aureus, one of about 30 different staphylococcal types which can cause human infections, are gram positive, spherical and gather in clusters. They are golden yellow in color and non-motile, tending to form clumps rather like small bunches of grapes. Any testing of material from the human nose, other mucus membrane or skin, especially near the genital and anal areas, is highly likely to be positive for the presence of staphylococcus aureus. MRS, first identified in 1994 and traced back to pigs ( according to Gonzalez, 2011) is also in this group of bacteria , but is much less prevalent, being present in only 1% of people according to Ostrosky-Zeichner ( 2009) In the case of staphylococcus aureus an American survey found its presence in 29% of the American population in 2003-2004 (Kuehnert et al 2006). Bobak in 2009 came up with a very similar figure of 25%. It is when the bacteria reach other places that problems begin and so it should always be considered as a possible pathogen. Often it enters the body through a break in the skin, thus overcoming the body’s own natural defense systems, but this is not always the case. Marrie et al (1982) found the bacteria as part of the normal flora in the urethras of 6% of normal, healthy women. According to Boyce ( 1996) those who have the bacteria already somewhere on their body are more likely to develop Staphyloccal based infections. Staphylococcus Infection Figure 1 Gram stained staphylococcus bacteria in pus When staphylococcus infection occurs it can come in several forms e.g. skin infections such as boils, furuncles and styes. The same bacteria can cause deep seated infections attacking the bones or the myocardium, and it can cause very serious conditions such as meningitis, urinary tract infections and pneumonia. For the purposes of this essay mainly one of these, urinary tract infection. This is much commoner in women than in men simply for anatomically reasons, although there is an increased risk in those who participate in rectal sex. There are a number of other at risk factors outlined on the WebMed website ( 2005). These include the presence of renal calculi, being pregnant, using an intrauterine contraceptive device, use of a catheter and having any condition which affects the nerve supply to the bladder such as diabetes and multiple sclerosis. It is also more likely to be a problem in old age when the body’s immune system becomes weaker. Muder et al ( 2006) found that among veterans in care who had staphylococcal urinary infections 82% had recently been catheterised. The American National Kidney and Urologic Disease Information Clearinghouse (NKUDIC) report that in the United States urinary tract infections account for 8.3 million visits to doctors in a year, so this is a very prevalent condition. Although Escherichia Coli , normally found in the intestine, is the commonest cause of urinary tract infection, other bacteria , including staphylococcus aureus, can cause such infections. Muder et al ( 2006) discuss how the infection can spread to become staphylococcal bacteraemia. Grandsen et al ( 1984) found it to be the causative organism in 17.5% of cases of bacteraemia in one hospital over a period of 14 years with a resultant 50% mortality rate, which underlines the possible seriousness of this condition, especially when one considers that , even then , the authors believed that 60% of these infections were acquired during the patient’s stay in the hospital. They state that when it came to treatment :- Microbiologists seldom influenced directly the choice of initial antibiotic treatment (though this usually conformed to the
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