Staphylococcus epidermidis: Difference between revisions
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===Antimicrobial therapy=== | ===Antimicrobial therapy=== | ||
*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. '''Methicillin-sensitive Staphylococcus epidermidis''' | |||
::* Preferred regimen (1): [[ | ::*Preferred regimen (1): [[Oxacillin]] 1-2 g IV q4h | ||
::* Preferred regimen (2): [[ | ::*Preferred regimen (2): [[Nafcillin]] 1-2 g IV q4h | ||
::* Preferred regimen (3): [[ | ::*Preferred regimen (3): [[Cephalothin]] | ||
::* Alternative regimen (1): [[ | ::*Alternative regimen (1): [[Rifampin]] 600 mg/day PO qd {{and}} [[Trimethoprim]]-[[Sulfamethoxazole]] | ||
::* Alternative regimen (2): [[ | |||
:* 2. '''Methicillin-resistant | ::*Alternative regimen (2): [[Fluoroquinolones]] {{and}} [[Daptomycin]] 600 mg PO/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> | ||
::* Preferred regimen: [[Vancomycin]] | ::*Note: 75% of the S. epidermidis are methicillin-resistant. | ||
:*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<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> | |||
:* | :*3. '''Prosthetic device infections''' | ||
::* Preferred regimen (1): [[Oxacillin]] 1-2 g IV q4h {{and}} [[Rifampin]] 600 mg/day PO qd {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM q8-24h | ::* Preferred regimen (1): [[Oxacillin]] 1-2 g IV q4h {{and}} [[Rifampin]] 600 mg/day PO qd {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM q8-24h | ||
::* Preferred regimen (2): [[Vancomycin]] 1 g IV q12h {{and}} [[Rifampin]] 600 mg/day PO qd {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM q8-24h.<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> | ::* Preferred regimen (2): [[Vancomycin]] 1 g IV q12h {{and}} [[Rifampin]] 600 mg/day PO qd {{and}} [[Gentamicin]] 3 mg/kg/day IV/IM q8-24h.<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> | ||
Latest revision as of 14:10, 12 August 2015
| Staphylococcus epidermidis/epidermis | ||||||||||||||
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| Scanning electron image of S. epidermidis. Scanning electron image of S. epidermidis.
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| Scientific classification | ||||||||||||||
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| Binomial name | ||||||||||||||
| Staphylococcus epidermidis (Winslow & Winslow 1908) Evans 1916 |
Staphylococcus epidermidis is a member of the bacterial genus Staphylococcus, consisting of Gram-positive cocci arranged in clusters. It is catalase-positive and coagulase-negative and occurs frequently on the skin of humans and animals and in mucous membranes.It is sensitive to the antibiotic Novobiocin; a feature that distinguishes it from the other common coagulase negative organism Staph. saprophyticus. Due to contamination, S. epidermidis is probably the most common species found in laboratory tests.
Although S. epidermidis is usually non-pathogenic, it is an important cause of infection in patients whose immune system is compromised, or who have indwelling catheters. Many strains produce a slime (biofilm) that allows them to adhere to the surfaces of medical prostheses.
S. epidermidis is often resistant to a wide variety of antibiotics, including penicillin and methicillin.
Colonies of S. epidermidis are typically small, white or beige, approximately 1-2 mm in diameter after overnight incubation. The organism is sensitive to desferrioxamine, and this test is used to distinguish it from almost all other staphylococci. Staphylococcus hominis, which is also sensitive, produces acid from trehalose, so it can usually be distinguished from S. epidermidis.
The normal practice of detecting S.epidermidis is by using the Baird Parker agar with egg yolk supplement. Colonies appeared in small, black colonies while confirmation can be done using coagulase test.
Treatment
Antimicrobial therapy
- Staphylococcus epidermidis[1]
- 1. Methicillin-sensitive Staphylococcus epidermidis
- Preferred regimen (1): Oxacillin 1-2 g IV q4h
- Preferred regimen (2): Nafcillin 1-2 g IV q4h
- Preferred regimen (3): Cephalothin
- Alternative regimen (1): Rifampin 600 mg/day PO qd AND Trimethoprim-Sulfamethoxazole
- Alternative regimen (2): Fluoroquinolones AND Daptomycin 600 mg PO/IV q12h[2]
- Note: 75% of the S. epidermidis are methicillin-resistant.
- 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[3]
- 3. Prosthetic device infections
- Preferred regimen (1): Oxacillin 1-2 g IV q4h AND Rifampin 600 mg/day PO qd AND Gentamicin 3 mg/kg/day IV/IM q8-24h
- Preferred regimen (2): Vancomycin 1 g IV q12h AND Rifampin 600 mg/day PO qd AND Gentamicin 3 mg/kg/day IV/IM q8-24h.[3]
de:Staphylococcus epidermidis nl:Staphylococcus epidermidis sr:Стафилококус епидермидис
Reference
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ Gilbert, David (2015). The Sanford guide to antimicrobial therapy. Sperryville, Va: Antimicrobial Therapy. ISBN 978-1930808843.
- ↑ 3.0 3.1 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.