Staphylococcus aureus pneumonia

　　Staphylococcus is a Gram-positive球菌, which can be divided into coagulase-positive yellow staphylococcus (mainly Staphylococcus aureus, abbreviated as S. aureus) and coagulase-negative staphylococcus (such as Staphylococcus epidermidis, etc.). The pathogenic substances of staphylococcus are mainly toxins and enzymes, which have hemolytic, necrotic, and leukocidal effects. Staphylococcus aureus pneumonia is more serious and is one of the main causes of pulmonary suppurative infection. In addition, staphylococcus in skin infection foci (such as boils, carbuncles, cellulitis, wound infection) can reach the lungs through the blood circulation, causing multiple pulmonary infections, which can form solitary or multiple pulmonary abscesses (hematogenous infection).

　　The complications of this disease are severe and may lead to death, such as progressive pneumonia, sometimes accompanied by adult respiratory distress syndrome or septic shock. Chest X-ray examination can show about 25% of patients have pleural effusion, and only about 1% of patients have empyema. Some patients may produce infections in adjacent areas of the lesions (such as empyema or purulent pericarditis). Bacteremia can cause infections outside the lungs, including septic arthritis, endocarditis, meningitis, and (ascites patients). Some patients may have repeated pulmonary infections, manifested as recurrence of fever and new pulmonary infiltrates during the treatment process, leading to deterioration of the condition.

　　This disease often starts suddenly, with symptoms such as chills, high fever, chest pain, purulent sputum, and sometimes blood-streaked sputum. There may also be symptoms such as muscle and joint pain, malaise, and in severe cases, early peripheral circulatory failure. Elderly symptoms may not be typical.

　　The main method of preventing Staphylococcus aureus pneumonia is to stay away from Staphylococcus aureus, and the following are common preventive measures:

　　1. Prevent the contamination of food by Staphylococcus aureus

　　Prevent contamination of various foods by pathogenic populations: Regular health checks for production and processing personnel, those with localized suppurative infections (such as scabies, finger abscesses, etc.), and upper respiratory tract infections (such as sinusitis, suppurative pneumonia, oral diseases, etc.) should temporarily stop their work or change their positions. For meat processing plants, the carcasses of birds and animals with localized suppurative infections should be removed of the diseased parts, processed and produced after high-temperature treatment or other appropriate methods.

　　2. Prevent the formation of Staphylococcus aureus enterotoxin

　　Food should be stored under low temperature and good ventilation conditions to prevent the formation of enterotoxins; in hot spring and summer, food should not be stored in refrigeration or ventilation cool places for more than 6 hours, and it should be thoroughly heated before eating. For patients with Staphylococcus aureus infection, erythromycin, new penicillin, gentamicin, vancomycin, or cefamycin VI can be chosen for treatment.

　　Staphylococcus aureus pneumonia is an acute suppurative inflammation of the lung caused by Staphylococcus aureus. Generally, the following examination items are needed to diagnose the disease:

　　1. Peripheral blood routine

　　Blood routine shows an increase in white blood cell count and percentage of neutrophils, with possible left shift and toxic granules.

　　2. Chest X-ray

　　Chest X-ray shows consolidation of lung segments or lobes, which can form cavities, or present as lobular infiltration, with single or multiple liquid-air cavities. Another characteristic is the variability of X-ray shadows, manifested as the disappearance of inflammatory infiltration in one place and the appearance of a new focus in another place, or the development of a small single focus into a large shadow.

　　3. Search for pathogenic bacteria

　　Search for pathogenic bacteria through sputum, pleural effusion, blood, etc.

　　According to the age characteristics of the child, provide nutritious and easily digestible food, and do not eat spicy and stimulating foods. For children who are breastfed, milk should be the main food, and a little water can be drunk appropriately. The milk can be diluted with a little water to make it thinner, feed less each time, and increase the frequency of feeding appropriately.

　　Antimicrobial drugs sensitive to the disease should be selected early in the treatment. In recent years, the resistance rate of Staphylococcus aureus to penicillin G has reached about 90%, so it is possible to choose semi-synthetic penicillins or cephalosporins that are resistant to penicillinase, such as sodium oxacillin, cefuroxime sodium, etc., in combination with aminoglycosides such as amikacin, which also have good efficacy. Combinations of amoxicillin, ampicillin, and β-lactamase inhibitors are effective against penicillinase-producing Staphylococcus aureus and can also be chosen. For methicillin-resistant Staphylococcus aureus, vancomycin and other drugs should be chosen. When selecting antimicrobial drugs, clinical reference should be made to the drug sensitivity test of bacterial culture.