Staphylococcus haemolyticus: Difference between revisions

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| binomial_authority = Schleifer & Kloos 1975
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'''''Staphylococcus haemolyticus''''' is a species of [[bacterium]] belonging to the [[genus]] ''[[Staphylococcus]]''. It is a [[Gram positive]] coccus, [[coagulase]] negative, and [[catalase]] positive. Frequently found as a [[commensal]] organism on the skin of humans and animals, ''S. haemolyticus'' occurs infrequently as a cause of soft-tissue infections, usually in [[immunocompromised]] patients. <ref name=Kufe> {{cite book | author = Rolston KVI, Bodey GP.  | title = Infections in Patients with Cancer. ''In:'' Cancer Medicine ''(Kufe DW ''et al'', eds.)| edition = 6th ed. | publisher = BC Decker | year = 2003 | id = [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Search&db=books&doptcmdl=GenBookHL&term=Staphylococcus+haemolyticus+AND+358549%5Buid%5D&rid=cmed6.section.43615#43625 (via NCBI Bookshelf)] ISBN 0-9631172-1-1 }}</ref>
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{{CMG}}


''S. haemolyticus'' is resistant to multiple antimicrobial agents.<ref name=Froggatt_1989>{{cite journal | author=Froggatt JW, Johnston JL, Galetto DW, Archer GL | title=Antimicrobial resistance in nosocomial isolates of Staphylococcus haemolyticus | journal=Antimicrob Agents Chemother | year=1989 | pages=460-6 | volume=33 | issue=4 | id={{PMID|2729941}} [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=172460 fulltext] }}</ref> Resistance to [[vancomycin]] has been recorded, and this is a cause for concern because such resistance could be acquired by other, more [[pathogen|pathogenic]] staphylococci.<ref Gemmell_2004>{{cite journal | author=Gemmell CG | title=Glycopeptide resistance in ''Staphylococcus aureus'': is it a real threat? | journal=J Infect Chemother | year=2004 | pages=69-75 | volume=10 | issue=2 | id={{PMID|15160298}} }}</ref>
==Overview==
'''''Staphylococcus haemolyticus''''' is a species of [[bacterium]] belonging to the [[genus]] ''[[Staphylococcus]]''. It is a [[Gram positive]] coccus, [[coagulase]] negative, and [[catalase]] positive. Frequently found as a [[commensal]] organism on the skin of humans and animals, ''S. haemolyticus'' occurs infrequently as a cause of soft-tissue infections, usually in [[immunocompromised]] patients.
 
''S. haemolyticus'' is resistant to multiple antimicrobial agents.<ref name=Froggatt_1989>{{cite journal | author=Froggatt JW, Johnston JL, Galetto DW, Archer GL | title=Antimicrobial resistance in nosocomial isolates of Staphylococcus haemolyticus | journal=Antimicrob Agents Chemother | year=1989 | pages=460-6 | volume=33 | issue=4 | id={{PMID|2729941}} [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=172460 fulltext] }}</ref> Resistance to [[vancomycin]] has been recorded, and this is a cause for concern because such resistance could be acquired by other, more [[pathogen|pathogenic]] staphylococci.


==Treatment==
==Treatment==
===Antimicrobial regimen===
===Antimicrobial regimen===
:* [[CoNS|Staphylococcus, coagulase-negative species (CoNS)]]
:* [[CoNS|Staphylococcus, coagulase-negative species (CoNS)]]
::* [[Staphylococcus epidermidis group (Staphylococcus epidermidis, Staphylococcus haemolyticus) ]]
:*Staphylococcus epidermidis<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
:::* 1. '''Bacteremia''': most often due to IV lines, vascular grafts, cardiac valves (30-40% of all coagulase-negative staphylococcus infections)
:*1. '''Methicillin-sensitive Staphylococcus epidermidis'''
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h with or without [[Rifampin]] 300 mg q8h IV/PO {{or}} [[Gentamicin]] 3 mg/kg/day IV q8h {{and}} [[Vancomycin]] {{and}} [[Rifampin]] 300 mg q8h IV/PO for prosthetic valve IE.
::* Preferred regimen (1): [[Oxacillin]] 1-2 g IV q4h
::::* Alternative regimen (methicillin resistent Staphylococcus epidermidis) (1): [[Linezolid]] 600 mg IV/PO bd {{or}} [[Daptomycin]] IV 6 mg/kg/day with or without [[Rifampin]] 300 mg q8h IV/PO.
::* Preferred regimen (2): [[Nafcillin]] 1-2 g IV q4h
::::* Alternative regimen (methicillin-sensitive Staphylococcus epidermidis) (2): ([[Oxacillin]] 1.5-3 g IV q6h {{or}} [[Nafcillin]] 1.5-3 g IV q6h), {{or}} [[Cefazolin]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Clindamycin]] 600 mg IV q8h {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]].
::* Preferred regimen (3): [[Cephalothin]]
::::: Note: Site sepcific recommendation for  peripheral line is to remove line, antibiotics for 5-7 days and for central line may often keep line and systemic antibiotics for 2 wks with antibiotics lock.
::* Alternative regimen: [[Rifampin]] 600 mg/day PO qd {{and}} [[Sulfamethoxazole]] and [[Trimethoprim]] ((or) [[Fluoroquinolones]]) {{and}} [[Daptomycin]] 600 mg PO or IV q12h<ref>{{cite book | last = Gilbert | first = David | title = The Sanford guide to antimicrobial therapy | publisher = Antimicrobial Therapy | location = Sperryville, Va | year = 2015 | isbn = 978-1930808843 }}</ref>
 
::* Note: 75% of the S. epidermidis are methicillin-resistant.
:::* 2. '''CSF shunt''': meningitis
:*2. '''Methicillin-resistant Staphylococcus epidermidis'''
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h with or without [[Rifampin]] 300 mg q8h IV/PO {{or}} [[Gentamicin]] 3 mg/kg/day IV q8h added to [[Vancomycin]] {{and}} [[Rifampin]] 300 mg IV/PO q8h for prosthetic valve IE.
::* Preferred regimen: [[Vancomycin]] 1 g IV q12h with or without [[Rifampin]] 600 mg/day PO qd
::::* Alternative regimen (methicillin resistent Staphylococcus epidermidis) (1): [[Linezolid]] 600 mg IV/PO bd {{or}} [[Daptomycin]] IV 6 mg/kg/day with or without [[Rifampin]] 300 mg IV/PO q8h.
::* Note: For deep-seated infections consider adding [[Gentamicin]] with or without [[Rifampin]] 600 mg/day PO qd to the regimen<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145  }} </ref>
::::* Alternative regimen (methicillin-sensitive Staphylococcus epidermidis) (2): ([[Oxacillin]] 1.5-3 g IV q6h {{or}} [[Nafcillin]] 1.5-3 g IV q6h), {{or}} [[Cefazolin]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Clindamycin]] 600 mg IV q8h {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]].
:*3. '''Prosthetic device infections'''
::::: Note: Shunt removal usually recommended but variable. [[Vancomycin]] 22.5 mg/kg IV q12h and [[rifampin]] PO/IV and possible intraventricular antibiotics: [[Vancomycin]] 20 mg/day with or without [[Gentamicin]] 4-8 mg/day is recommended.
::* Preferred regimen: [[Oxacillin]] 1-2 g IV q4h ((or) [[Vancomycin]] 1 g IV q12h) {{and}} [[Rifampin]] 600 mg/day PO qd {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM q8-24h is appropriate<ref name="pmid15956145">{{cite journal| author=Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME et al.| title=Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. | journal=Circulation | year= 2005 | volume= 111 | issue= 23 | pages= e394-434 | pmid=15956145 | doi=10.1161/CIRCULATIONAHA.105.165564 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15956145  }} </ref>
 
::* Note: Duration depends on site of infection and severity.
:::* 3. '''Peritoneal dialysis catheter''': peritonitis
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h with or without [[Rifampin]] 300 mg q8h IV/PO {{or}} [[Gentamicin]] 3 mg/kg/day IV q8h added to [[Vancomycin]] {{and}} [[Rifampin]] 300 mg q8h IV/PO for prosthetic valve IE.
::::* Alternative regimen (methicillin resistent Staphylococcus epidermidis) (1): [[Linezolid]] 600 mg IV/PO bd {{or}} [[Daptomycin]] IV 6 mg/kg/day with or without [[Rifampin]] 300 mg q8h IV/PO.
::::* Alternative regimen (methicillin-sensitive Staphylococcus epidermidis) (2): ([[Oxacillin]] 1.5-3 g IV q6h {{or}} [[Nafcillin]] 1.5-3 g IV q6h), {{or}} [[Cefazolin]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Clindamycin]] 600 mg IV q8h {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]].
::::: Note: Site sepcific recommendation is to keep dialysis catheter (at least for first effort) and IV [[Vancomycin]] (usually 2 g IV/wk and redose when level <15 mcg/mL) with antibiotics lock for 10-14 days.
 
:::* 4. '''Prosthetic joint''': septic arthritis
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h with or without [[Rifampin]] 300 mg q8h IV/PO {{or}} [[Gentamicin]] 3 mg/kg/day IV q8h added to [[Vancomycin]] {{and}} [[Rifampin]] 300 mg q8h IV/PO for prosthetic valve IE.
::::* Alternative regimen (methicillin resistent Staphylococcus epidermidis) (1): [[Linezolid]] 600 mg IV/PO bd {{or}} [[Daptomycin]] IV 6 mg/kg/day with or without [[Rifampin]] 300 mg q8h IV/PO.
::::* Alternative regimen (methicillin-sensitive Staphylococcus epidermidis) (2): ([[Oxacillin]] 1.5-3 g IV q6h {{or}} [[Nafcillin]] 1.5-3 g IV q6h), {{or}} [[Cefazolin]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Clindamycin]] 600 mg IV q8h {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]].
::::: Note: Site sepcific recommendation is typically remove joint (two stage more common than single stage replacement), antibiotics for 6 wks. If very early infection (less than 3 wks post-op, debridement and retention an option).
 
:::* 5. '''Prosthetic or natural cardiac valve''': endocarditis
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h with or without [[Rifampin]] 300 mg q8h IV/PO {{or}} [[Gentamicin]] 3 mg/kg/day IV q8h added to [[Vancomycin]] {{and}} [[Rifampin]] 300 mg q8h IV/PO for prosthetic valve IE.
::::* Alternative regimen (methicillin resistent Staphylococcus epidermidis) (1): [[Linezolid]] 600 mg IV/PO bd {{or}} [[Daptomycin]] IV 6 mg/kg/day with or without [[Rifampin]] 300 mg q8h IV/PO.
::::* Alternative regimen (methicillin-sensitive Staphylococcus epidermidis) (2): ([[Oxacillin]] 1.5-3 g IV q6h {{or}} [[Nafcillin]] 1.5-3 g IV q6h), {{or}} [[Cefazolin]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Clindamycin]] 600 mg IV q8h {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]].
::::: Note: Site sepcific recommendation is consider valve replacement and antibiotics for 6 wks.
 
:::* 6. '''Post-sternotomy''': osteomyelitis
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h with or without [[Rifampin]] 300 mg q8h IV/PO {{or}} [[Gentamicin]] 3 mg/kg/day IV q8h added to [[Vancomycin]] {{and}} [[Rifampin]] 300 mg q8h IV/PO for prosthetic valve IE.
::::* Alternative regimen (methicillin resistent Staphylococcus epidermidis) (1): [[Linezolid]] 600 mg IV/PO bd {{or}} [[Daptomycin]] IV 6 mg/kg/day with or without [[Rifampin]] 300 mg q8h IV/PO.
::::* Alternative regimen (methicillin-sensitive Staphylococcus epidermidis) (2): ([[Oxacillin]] 1.5-3 g IV q6h {{or}} [[Nafcillin]] 1.5-3 g IV q6h), {{or}} [[Cefazolin]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Clindamycin]] 600 mg IV q8h {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]].
 
:::* 7. '''Implants (breast, penile, pacemaker) and other prosthetic devices''': local infection
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h with or without [[Rifampin]] 300 mg q8h IV/PO {{or}} [[Gentamicin]] 3 mg/kg/day IV q8h added to [[Vancomycin]] {{and}} [[Rifampin]] 300 mg q8h IV/PO for prosthetic valve IE.
::::* Alternative regimen (methicillin resistent Staphylococcus epidermidis) (1): [[Linezolid]] 600 mg IV/PO bd {{or}} [[Daptomycin]] IV 6 mg/kg/day with or without [[Rifampin]] 300 mg q8h IV/PO.
::::* Alternative regimen (methicillin-sensitive Staphylococcus epidermidis) (2): ([[Oxacillin]] 1.5-3 g IV q6h {{or}} [[Nafcillin]] 1.5-3 g IV q6h), {{or}} [[Cefazolin]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Clindamycin]] 600 mg IV q8h {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]].  
::::: Note: Site sepcific recommendation for vascular graft is to remove graft, antibiotics for 6 wks.
 
:::* 8. '''Post-ocular surgery''': endophthalmitis
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h with or without [[Rifampin]] 300 mg q8h IV/PO {{or}} [[Gentamicin]] 3 mg/kg/day IV q8h added to [[Vancomycin]] {{and}} [[Rifampin]] 300 mg q8h IV/PO for prosthetic valve IE.
::::* Alternative regimen (methicillin resistent Staphylococcus epidermidis) (1): [[Linezolid]] 600 mg IV/PO bd {{or}} [[Daptomycin]] IV 6 mg/kg/day with or without [[Rifampin]] 300 mg q8h IV/PO.
::::* Alternative regimen (methicillin-sensitive Staphylococcus epidermidis) (2): ([[Oxacillin]] 1.5-3 g IV q6h {{or}} [[Nafcillin]] 1.5-3 g IV q6h), {{or}} [[Cefazolin]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Clindamycin]] 600 mg IV q8h {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]].  
 
:::* 9. '''Surgical site infections'''
::::* Preferred regimen: [[Vancomycin]] 15 mg/kg IV q12h with or without [[Rifampin]] 300 mg q8h IV/PO {{or}} [[Gentamicin]] 3 mg/kg/day IV q8h added to [[Vancomycin]] {{and}} [[Rifampin]] 300 mg q8h IV/PO for prosthetic valve IE.
::::* Alternative regimen (methicillin resistent Staphylococcus epidermidis) (1): [[Linezolid]] 600 mg IV/PO bd {{or}} [[Daptomycin]] IV 6 mg/kg/day with or without [[Rifampin]] 300 mg q8h IV/PO.
::::* Alternative regimen (methicillin-sensitive Staphylococcus epidermidis) (2): ([[Oxacillin]] 1.5-3 g IV q6h {{or}} [[Nafcillin]] 1.5-3 g IV q6h), {{or}} [[Cefazolin]] 1-2 g IV q8h {{or}} [[Ciprofloxacin]] 400 mg IV q12h {{or}} [[Clindamycin]] 600 mg IV q8h {{or}} [[Trimethoprim]]-[[Sulfamethoxazole]].
::::: Note: only assume [[Methicillin]] susceptible if multiple isolates are so identified.


==References==
==References==

Latest revision as of 15:40, 6 August 2015

Staphylococcus haemolyticus
Scientific classification
Kingdom: Bacteria
Phylum: Firmicutes
Class: Bacilli
Order: Bacillales
Family: Staphylococcaceae
Genus: Staphylococcus
Species: S. haemolyticus
Binomial name
Staphylococcus haemolyticus
Schleifer & Kloos 1975

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Staphylococcus haemolyticus is a species of bacterium belonging to the genus Staphylococcus. It is a Gram positive coccus, coagulase negative, and catalase positive. Frequently found as a commensal organism on the skin of humans and animals, S. haemolyticus occurs infrequently as a cause of soft-tissue infections, usually in immunocompromised patients.

S. haemolyticus is resistant to multiple antimicrobial agents.[1] Resistance to vancomycin has been recorded, and this is a cause for concern because such resistance could be acquired by other, more pathogenic staphylococci.

Treatment

Antimicrobial regimen

  • 2. Methicillin-resistant Staphylococcus epidermidis
  • Preferred regimen: Vancomycin 1 g IV q12h with or without Rifampin 600 mg/day PO qd
  • Note: For deep-seated infections consider adding Gentamicin with or without Rifampin 600 mg/day PO qd to the regimen[4]
  • 3. Prosthetic device infections
  • Preferred regimen: Oxacillin 1-2 g IV q4h ((or) Vancomycin 1 g IV q12h) AND Rifampin 600 mg/day PO qd AND Gentamicin 3 mg/kg/day IV/IM q8-24h is appropriate[4]
  • Note: Duration depends on site of infection and severity.

References

  1. Froggatt JW, Johnston JL, Galetto DW, Archer GL (1989). "Antimicrobial resistance in nosocomial isolates of Staphylococcus haemolyticus". Antimicrob Agents Chemother. 33 (4): 460–6. PMID 2729941 fulltext.
  2. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  3. Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
  4. 4.0 4.1 Baddour LM, Wilson WR, Bayer AS, Fowler VG, Bolger AF, Levison ME; et al. (2005). "Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America". Circulation. 111 (23): e394–434. doi:10.1161/CIRCULATIONAHA.105.165564. PMID 15956145.

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