Staphylococcus Aureus Medical Malpractice

A wide variety of infections can be caused by the Staphylococcus bacteria. The strain, severity, and location of infection will effect how it manifests. Staph is responsible for a number of skin ailments including boils, impetigo, cellulitis and scalded skin syndrome. It is also a common cause of food poisoning. Bacteremia can occur when staph enters a person's bloodstream, where it may travel to internal organs, bones and/or muscle. Staph is also the bacteria responsible for toxic shock syndrome, a potentially fatal condition in which toxins produced by a certain strain of staph cause a life threatening drop in blood pressure, accompanied by high fever and vomiting. Those afflicted may enter into hypotensive shock in which their lungs and heart stop working. TSS has been associated with the use of super-absorbent tampons. Septic arthritis may be caused by a staph infection.

The bacterium is found in the noses of approximately 30% of general population, without creating complications for those who carry it. Staph I can be spread via skin-to-skin contact or typical sharing behavior of personal items. It is resilient and does not require host-to-host transfer; it can easily survive on common items before it being contracted by a new host. Staph bacteria can even survive high levels of salt, extreme temperatures, and stomach acid. It is highly contagious, with a greater incidence in communal areas such as dorms, barracks, locker rooms and other spaces in which there is a high concentration of people frequently making contact with one another.

Staph infections are fairly common, with more than 3 million cases in the US annually. They are usually short term, treatable by a medical professional, require diagnosis/lab testing and resolve within days to weeks. Although the incidence of staph infections does not vary between age groups, susceptibility considerably increases after age 60.

Causes of Staph Infections

Although skin and mucous membranes provide effective barriers to infection from the myriad bacteria that live on our skin, a staph infection may occur when the barrier is broken or otherwise compromised. For example, a cut, scab, sore or surgical wound could potentially become infected with staph if touched by anything carrying staph, be it skin or an object.

Despite rigorous efforts to eliminate it in hospitals, the presence of staph remains a problem, where it may be more easily transmitted to vulnerable individuals. The bacteria can gain access through a wound or via the respiratory tract where it can progress to infection.

Staph may be transmitted by contact as harmless as a handshake. It can also spread by sharing personal items such as razors and towels.

Symptoms of Staph

In the case of skin maladies, staph infections usually begin as a localized collection of pus. It may manifest as a boil or abscess. The area becomes red, swollen and tender and may drain or even “weep” pus if it is especially severe. The site may also be itchy.

Symptoms will depend on the type of infection. Food poisoning associated with staph is accompanied by malaise, nausea, vomiting, diarrhea and abdominal pain, with symptoms usually appearing within 6 hours of consumption of the contaminated food. Notably, staph food poisoning is not usually accompanied by fever.

Fever becomes possible when staph enters your bloodstream, inducing a condition known as bacteremia which may have life threatening complications. Symptoms of bacteremia include muscle and joint pain, night sweats, a fever, pale skin, nausea.

Cellulitis, which most often appears on the legs, will often produce redness and swelling on the area with no pus. Impetigo, however, is accompanied by a yellowish crusting of the skin, the occasional “weeping” of fluid from the skin and blisters.

Treatment/Prognosis

Staph infections can usually be treated with antibiotics, although some may require surgery depending on the severity of the infection. One variety of staph known as MRSA is resistant to a number of first line antibiotics used in the treatment of normal staph infections. The combination of antibiotics used will be determined after a sample is collected from the infected area.

These antibiotics include:

  • nafcillin [Nallpen, Unipen]
  • cefazolin [Ancef, Kefzol]
  • dicloxacillin [Dycill, Dynapen]
  • clindamycin [Cleocin T, Clindagel, ClindaMax, ClindaReach Pledget, Evoclin]
  • trimethoprim-sulfamethoxazole [Bactrim, Bactrim DS, Septra, Septra DS, SMZ-TMP DS, Sulfatrim Pediatric]
  • doxycycline [Oracea].

Risk Factors

Certain factors place people at a higher risk of developing staph infections. These conditions include those who are breastfeeding, have cancer, skin injuries and disorders, surgical wounds, intravenous catheters, weakened immune systems, vascular or lung disease or who inject drugs or medications. Infants are also more susceptible to staph infection.

As staph is contagious until resolved with antibiotics, therefore if a family member, friend, coworker or another person with whom contact may be made has staph, there is an increased risk of contracting it. Any direct contact with an infected area or secondary contact via shared items such as razors and bandages can be a route of transmission for the bacteria. Other forms of casual contact do not pose a great risk so long as there is no contact with a staph-infected area.

Preventing Staph in Hospitals

The foremost means of protecting against staph infection is to practice good personal hygiene and to wash hands frequently. In hospitals, however, greater care must be taken to guard against the spread of staph infection. Because of the prevalence of open wounds, chest tubes, catheters, and IVs in hospitals, patients are especially vulnerable to contracting staph. Despite efforts to eradicate it, cases still arise.

Clean hands are critical in preventing the spread of staph. Both soap and alcohol based gels are acceptable. Health care providers should take care to wash hands before and after contact with every patient. Gloves and other protective clothing should be worn when treating wounds, touching IVs and catheters or handling bodily fluids. Using proper sterilization techniques is key in preventing staph infection in hospitals. Patients should be diligently checked for any sign of wound infection.

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