Diseases Caused by Staphylococcal infection and Toxin
Session 9: Diseases Caused by Staphylococcal infection and Toxin
Total Session Time: 60 minutes
Pre-requisites
Students Learning Tasks
By the end of this session students are expected to be able to:
signs and symptoms)
staphylococcal infection diseases
Resources Needed:
SESSION OVERVIEW
|Step |Time |Activity/ |Content |
| | |Method | |
|1 |5 minutes |Presentation |Introduction, Learning Tasks |
|2 | 15 minutes|Presentation |Staphylococcal Food Poisoning |
|3 |15 minutes |Presentation |Toxic Shock Syndrome |
|4 |15 minutes |Presentation |Signs and Symptoms of Syphilis |
|5 |5 minutes |Presentation |Key Points |
| 6|5 minutes |Presentation |Evaluation |
SESSION CONTENTS
STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ASK students if they have any questions before continuing
STEP 2: Staphylococcal Food Poisoning (15 minutes)
o Staphylococcal food poisoning is caused by ingesting food
containing a preformed heat-stable staphylococcal enterotoxin
o Food can be contaminated by staphylococcal carriers or people with
active skin infections
o In food that is incompletely cooked or left at room temperature,
staphylococci reproduce and elaborate enterotoxin
o Many foods can serve as growth media, and despite contamination,
they have a normal taste and odor
o Common food products are meat, fish, milk or milk products
o Incubation period is 1-8 hours after ingesting contaminated food
o Severe nausea and vomiting
o Abdominal cramps and diarrhea
o Resolves in 24 hours
o Treatment
o Prevention
STEP 3: Toxic Shock Syndrome (15 minutes)
o Toxic shock syndrome is a rare, life-threatening complication of
certain types of bacterial infections
o Often toxic shock syndrome results from toxins produced by
Staphylococcus aureus
o Group A streptococci (Streptococcus pyogenes) also produce toxin
that causes toxic shock syndrome
o Disease occurs following production of exotoxin by the bacteria
infecting a wound or colonizing a device or tampon in the body
(vaginal tampons or tampon to control nose bleeding)
o TSS may also occur following staphylococcal or streptococcal soft
tissue infections. The toxin enters bloodstream through
skin/mucosal break or via the uterus
o Toxic shock syndrome can affect anyone including men, children and
postmenopausal women
o Women who have preexisting staphylococcal colonization of the
vagina and who leave tampons or other devices such as contraceptive
sponges or diaphragms in the vagina.
o Also, skin wounds and surgery are risk factors for staphylococcal
toxic shock syndrome
o Onset of Toxic Shock Syndrome is sudden, with
organ systems)
o Staphylococcal TSS is likely to cause vomiting, diarrhea, myalgia,
mucositis, hepatic damage, thrombocytopenia, and confusion.
particularly on the palms and soles, between 3 and 7 days
after onset
o Streptococcal TSS commonly causes acute respiratory distress
syndrome (ARDS), coagulopathy, and hepatic damage and is more
likely to cause fever, malaise, and severe pain at the site of a
soft-tissue infection
o Renal impairment is frequent and common to both. The syndrome may
progress within 48 h to syncope, shock, and death. Less severe
cases of staphylococcal TSS are fairly common
o Local measures
surgical wounds even they appear healthy
(sinuses, vagina)
o Fluid resuscitation and circulatory support
hypovolemia, hypotension, and shock
o Empiric antibiotic therapy
Oxacillin
o Preventive measures
STEP 4: Staphylococcal Scalded Skin Syndrome (15 minutes)
o Staphylococcal Scalded Skin Syndrome (SSSS) is an acute
epidermolysis caused by a staphylococcal toxin
o Infants and children are most susceptible
o Staphylococcal scalded skin syndrome (SSSS) is caused by coagulase-
positive staphylococci which produce a toxin (exfoliatin or
epidermolysin) that separate the upper part of epidermis from
underlying tissue
o The primary infection often begins during the first few days of
life in the umbilical stump or diaper area
affects the entire skin.
o The initial lesion is usually superficial and crusted
o Within 24 hours, the surrounding skin becomes painful and scarlet,
changes that quickly spread to other areas
o The skin may be exquisitely tender and have a wrinkled tissue
paper–like consistency
o Large, flaccid blisters arise on the erythematous skin and quickly
break to produce erosions
o Blisters are frequently present in areas of friction, such as
intertriginous areas, buttocks, hands, and feet
o Intact blisters extend laterally with gentle pressure (Nikolsky
sign)
o The epidermis may peel easily, often in large sheets
o Widespread desquamation occurs within 36 to 72 hours and patients
become very ill with systemic manifestations (e.g. malaise, chills,
fever)
o Desquamated areas appear scalded
o Loss of the protective skin barrier can lead to sepsis and to fluid
and electrolyte imbalance
o Antibiotics
staphylococcus, MRSA)
STEP 5: Key Points (5 minutes)
Staphylococcus aureus and Streptococcus pyogenes.
diffuse erythematous rash, and multiple organ dysfunction
positive staphylococci which produce a toxin (exfoliatin or
epidermolysin) that separate the upper part of epidermis from
underlying tissue, mostly occurring in infants and young children
contaminated with Staphylococci
STEP 6: Evaluation (5 minutes)
References
Hugo and Russell (2011), Pharmaceutical Microbiology 8th Edition, Willey-
Blackwel publications
Karen C. Carroll et al (2013); Jawetz, Melnick and Adelberg’s Medical
Microbiology 26th Ed. McGraw Hill Co. Inc.
Greenwood et al (2012); Medical Microbiology, 18th edition Churchill
Livingstone
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