Staphylococcus Aureus

A 16-month-old female is admitted to the PICU with fever and concerns for sepsis. A few weeks earlier, she had the onset of a generalized maculopapular rash. The rash seemed to wax and wane, and then 4 days prior to admission, she was seen and treated with oral amoxicillin for fever and acute otitis media. The rash had since transitioned into several dark skin lesions with some surrounding erythema. Several lesions had become significantly larger, especially a presacral lesion (Figure 1), as well as lesions on both upper and lower lips (Figure 2) and her right ankle. A swab of the surface of the presacral lesion was sent for routine bacterial culture, growing three organisms: methicillin-sensitive Staphylococcus aureus (MSSA), Enterobacter and Klebsiella.

Parental application of nasal antibiotic ointment and use of antiseptic wipes may significantly reduce parent-to-infant transmission of Staphylococcus aureus in the NICU, according to study results published in JAMA.

Published research suggests access-related Staphylococcus aureus bacteremia rates were nearly seven-times higher for patients on hemodialysis who were cannulated using the buttonhole needling technique compared with stepladder/area puncture.

A previously healthy, 2-month-old male is admitted to the hospital with an unusual blistering rash in the diaper area. The onset was a few days earlier, but since then, additional lesions have developed. There has been no fever reported or other concerning symptoms, such as nausea, vomiting, diarrhea, coughing or any other rash or skin findings. The baby’s appetite is normal and unchanged, and there have been no sick contacts. He is on no medications.

Experts are developing and testing numerous vaccine candidates against norovirus, which causes hundreds of millions of infections each year worldwide and is seen as a top target for vaccine research. Infectious Disease News asked C. Buddy Creech, MD, MPH, and Leigh M. Howard, MD, MPH, of the Vanderbilt Vaccine Research Program and division of pediatric infectious diseases at Vanderbilt University Medical Center, what the world’s top vaccine priorities are.

A survey among members of the Infectious Diseases Society of America’s Emerging Infection Network showed that the majority of adult infectious disease physicians would shift patients with both gram-negative and gram-positive bacteremia to oral antibiotics for treatment.

Among the top stories in infectious disease this past week included an announcement that four European countries had lost their measles elimination status — a major setback the United States may soon experience as well. Also, a small pilot study demonstrated that pharmacists can play a central role in improving uptake of HIV pre-exposure prophylaxis, or PrEP.

The incidence rate of Staphylococcus aureus infection declined nearly 50% over 7 years among veterans undergoing major surgery, according to findings from “one of the largest studies describing the long-term incidence of S. aureus in the surgical population of a national integrated health care system.”

A 15-year-old healthy male presented to the dermatology clinic for evaluation of a lesion on the right forearm. He first noticed it approximately 1 year ago. At that time, it was a hard, pink papule, which he thought was an insect bite. The lesion continued to enlarge over time. In the last month, it developed white papules within it. It has never drained. An attempt to perform an incision and drainage with his primary care provider 1 week before revealed blood rather than purulent drainage, with no improvement in the lesion. It is occasionally painful if bumped but otherwise asymptomatic.

According to research published in Trends in Microbiology, patients with atopic dermatitis, or AD, are commonly colonized with Staphylococcus aureus during flares. Bleach baths are one way clinicians are trying to reduce S. aureus colonization in AD patients and subsequently reduce disease severity.