Klebsiella And Staphylococcus Aureus In Infants And Newborns - Symptoms, Why Is It Dangerous?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Klebsiella and Staphylococcus aureus in infants

According to historical statistics, infant mortality in the Russian Empire significantly exceeded the overall European indicators. The reason for this was the lack of antibacterial drugs, neglect of basic sanitary and hygienic standards for caring for babies and their congenital weakness due to poor health and sometimes exhaustion of parents. Most often, children were struck by intestinal infections caused by pathogens such as Staphylococcus aureus. Then only about 75% of babies survived to one year of age.

Due to the poor nutrition, women in labor had difficulties with lactation. It is obvious that without mother's milk the situation with infant mortality was aggravated - the child did not receive protective substances, and therefore his immunity remained vulnerable and did not perform its functions in full. In such difficult conditions, the baby's body was forced to fight multiple pathogens on its own.

The widespread use of antibacterial drugs and antiseptic agents designed to fight pathogenic microorganisms has somewhat improved the situation. However, as it turned out, the aspirations of pediatricians and infectious disease doctors for a successful solution to the problem turned out to be premature.

The problem was that bacteria of the genus Staphylococcus and Enterococcus (Staphylococcus aureus and Klebsiella) possessed great resistance to drugs and no less adaptability to any unfavorable conditions.

In the last 30-50 years, with the massive spread of antibiotics, dubious therapeutic practice has also come: with or without doctors recommend taking antibacterial drugs to absolutely everyone, from patients with a common cold to cancer patients. In a short time, pathogenic microorganisms have changed so much that they have now become a huge problem for maternity hospitals and children's departments of hospitals.

Evidence for mutation of pathogenic flora, as they say, is evident:

• Staphylococcus aureus has learned to produce new enzymes that destroy antibacterial substances;
• In addition, the pathogen rebuilt and began to live in complex colonies, insensitive to antibiotics.

Scientists' studies show that single, scattered representatives of the pathogenic microflora are sensitive to almost all antibiotics, including the most common penicillin. The same effect was achieved when staphylococci lived in familiar small colonies.

Nobody took into account that bacteria have long ceased to exist in the form of single-layer settlements. Now they live in multi-layered colonies. The antibacterial agent destroys only the top layer or the bottom layer, and the rest of the bacteria safely continue their vital activity.

These two properties of Staphylococcus aureus have turned a seemingly harmless bacterium into a formidable enemy. Staphylococcus aureus is a real scourge of hospitals. It is extremely difficult to deal with it, and neither cosmetic repairs nor ultraviolet treatment will help here.

It often happens that hospital workers themselves become carriers of staphylococcus.

Content:

• Symptoms of staphylococcus in infants
• What is the danger of staphylococcus aureus in infants?
• Treatment of staphylococcus in infants
• Prevention of staphylococcus in infants

Symptoms of staphylococcus in infants

Staphylococcus infection manifests itself rather quickly. Staphylococcus aureus is an extremely aggressive and virulent pathogenic microorganism that reveals its presence almost immediately after infection. The norm of the content of Staphylococcus aureus in the body is zero. If the infection occurred in a maternity hospital, then by 2-5 days the baby begins to have problems with the gastrointestinal tract.

The main symptom is frequent bowel movements. However, even in a healthy infant who is breastfed, bowel movements can be regular and fairly frequent.

In this case, the disease can be identified based on additional symptoms:

• Skin rashes (pustules, boils, etc.);
• Long-lasting non-healing navel;
• Gushing regurgitation;
• The appearance of greenery, pus, blood in the stool;
• Changes in the color and structure of the stool: stool yellow or greenish, frothy.

Children over one month old suffer from staphylococcal infection somewhat less often, and their symptoms are different. In such children, the disease passes as gastroenterocolitis or toxic infection.

Defeat by toxicoinfectious type

Staphylococcus aureus often forms colonies on the surface of food. In the course of its vital activity, the microorganism actively produces enterotoxins. After eating contaminated foods, both the bacteria themselves and the toxins produced by them enter the child's body.

Symptoms include:

• Signs of general intoxication of the body (increase in body temperature to 37.5-39.0, headache, weakness and lethargy, drowsiness, nausea);
• Pallor of the skin;
• Frequent vomiting and diarrhea.

Most often, the child's body is attacked by bacteria when eating the following foods:

• Fermented milk products: milk, cottage cheese, kefir, etc.;
• Fruit and vegetable juices;
• Baby food from jars.

Parents who constantly feed their child with store-bought food are especially at risk. As you know, such products are often incorrectly transported and stored.

Any doctor from the Children's Infectious Diseases Hospital can tell about the multitude of patients under two years old, fed by the expired "Agusha", "Frutonyanya" or "Rastishka" and who were admitted to the hospital with severe poisoning.

Children infected with staphylococcus carry the disease much harder than adults:

• A high degree of intoxication leads to the fact that the child practically refuses to eat;
• Frequent diarrhea and vomiting lead to dehydration and excretion of electrolyte salts from the body. As a result, metabolism is significantly impaired;
• If the child has frequent manifestations of toxicoinfection, while they are severely manifested (pallor after vomiting, problems with sleeping and waking up), the child should be immediately transported to the hospital on their own or by calling an ambulance.

Lesion by the type of gastroenterocolitis

The acidity of a child's stomach does not have the same degree as that of an adult. Staphylococcus in the course of life produces a lot of enzymes and toxins that destroy the cellular structures of the mucous membranes. The result is damage to the mucous membrane of the stomach, small and large intestines. The so-called gastroenterocolitis develops.

The disease includes two components:

1. Gastritis. In children, the disease is expressed in food refusal and frequent vomiting. It is not so easy without special knowledge to distinguish vomiting from natural regurgitation. To draw the correct conclusion, you need to keep in mind that experts refer to vomiting in an infant as a volume of vomit in excess of three tablespoons. Spitting up more than three times a day is also considered pathological.

   • Gastritis in children is accompanied by symptoms of intoxication, as well as respiratory disorders (breathing is hoarse or noisier);
   • The child's voice becomes hoarse;
   • The sucking reflex weakens;
   • Dry lips are observed. The eyeballs visually sink deeper;
   • The peritoneal wall loses its tone. As a result of a functional test (pinching the skin), the fold straightens slowly. This indicates dehydration of the body.

   It is impossible to cope with the disease at home, you should immediately transport the child to a hospital and begin specific therapy.

2. Enterocolitis. It is a lesion of the mucous membrane of the large and small intestines. For diagnostic purposes, feces are analyzed. Normally, staphylococcus aureus in feces should not be detected, however, a small amount is recognized as the norm, since even children's immunity is able to suppress the infection. For the diagnosis of infectious enterocolitis, the staphylococcus content in the feces should be 10 to the power of 2 colony-forming units per gram.

The clinical picture is typical for severe colitis:

• Frequent diarrhea mixed with mucus, pus, blood;
• Light yellow feces, on contact with atmospheric air, takes on a green tint;
• Milk is not fully processed in the body. Lumps of curdled milk are found in the stool;
• After several bowel movements, the feces lose their structure and take the form of yellowish or green water;
• Wandering abdominal pain;
• The child becomes restless. The picture is similar to intestinal colic (pulls the legs to the stomach, screams, etc.);
• Bloating and increased production of intestinal gas (bubbling in the abdomen), frequent passing of gas;
• Signs of dehydration develop gradually: dry skin, loss of elasticity of the skin, retraction of the eyeballs, etc.

It is quite simple to determine the pathology by the number of bowel movements during the day. If a breastfed baby empties the intestines 7-10 times, this is not the norm. In children on artificial feeding, the normal number of bowel movements is 1-2 times a day.

The presence in the structure of feces of foreign impurities (blood, mucus, pus) always speaks of a pathological process in the area of the large or small intestine.

If the number of staphylococci in the feces is less than a certain norm, a diagnosis of dysbiosis is made. It often happens that pediatricians and when the specified value is exceeded, they talk about dysbiosis. However, in this case we are talking about infectious enterocolitis. Accordingly, the treatment should be different.

Klebsiella symptoms in infants

Klebsiella belongs to conditionally pathogenic microorganisms, since it is constantly present in the human body. These bacteria hold the record for the frequency of intestinal infections they cause. Most often, Klebsiella affects the intestines, that is, it belongs to enterobacteria. However, when it gets into the nasal mucosa, it can cause ozena (fetid rhinitis).

Most often, Klebsiella enters the child's body precisely in a hospital setting.

There are several reasons for infection:

• Adults often neglect the rules of personal hygiene and sanitation of household items. Klebsiella usually enters the child's body precisely after contact with the hands of an adult carrier or dirty objects;
• Often Klebsiella infects infants in the process of interacting with public toys in clinics and hospitals;
• Contact with a dirty pacifier. If the pacifier falls on the changing table or on the floor, parents will often wipe (and sometimes suck) the item and place it back into their child's mouth. This is a direct route to infection.

Klebsiella as a whole is characterized by the same symptomatic complex. However, unlike Staphylococcus aureus, the bacterium is less aggressive and affects mainly children with weakened immunity, dysbiosis or existing staphylococcal infection.

The main clinical difference between Klebsiella and staphylococcus is the color of the feces. If with staphylococcal infection the feces are light yellow, then with the defeat of Klebsiella it is dark green. Klebsiella is also characterized by more active gas formation.

What is the danger of staphylococcus aureus in infants?

In the absence of adequate antibiotic therapy, staphylococcal disease leads to many serious and deadly complications:

• Development of dehydration. Prolonged and painful diarrhea, as well as frequent vomiting, lead to the fact that water is excreted from the body at a tremendous rate along with electrolyte salts. The body is not able to bring all systems into a state of dynamic equilibrium (homeostasis). As a result, shock and death can occur. In children, dehydration begins much earlier due to less fluid in the body;
• Infectious toxic shock. Staphylococcus aureus is one of the leaders in reproduction rate. As mentioned, the bacterium produces many toxic substances. With excessive multiplication of toxins and enzymes, there are so many that the body loses the ability to maintain all the necessary vital functions: kidneys, heart, liver and brain fail;
• Intestinal bleeding. Prolonged enterocolitis leads to destruction of the intestinal epithelium, perforation of its walls and massive bleeding;
• Peritonitis. With perforation of the walls, food and feces go beyond the intestine, infecting the abdominal cavity;
• Sepsis. By destroying the intestinal walls, staphylococcus aureus can enter the bloodstream. This will lead to blood poisoning, and the risk of death will increase many times over;
• Development of carriage of Staphylococcus aureus. Even if the treatment is carried out in a timely and effective manner, there is a risk of developing a carrier of the bacteria. The microorganism begins to exist in a latent form. Clinically, carriage resembles a sluggish dysbiosis: decreased appetite, instability of the stool, diarrhea alternating with constipation and periods of normal bowel function, heaviness in the abdomen, bloating, flatulence (colic), frequent regurgitation.

Over time, either staphylococcus aureus is re-activated, or the child's immune system, together with bifidumbacteria, "pacify" the pathogen.

Treatment of staphylococcus in infants

Therapy of an infectious lesion with staphylococcus is reduced to three main aspects:

• Establishing control over the intensity of the reproduction of the microorganism, the destruction of pathogens by the method of sanitation and the intake of bacteriophages;
• Supportive treatment (restoring water balance in the body, prescribing medical nutrition);
• It is absolutely unacceptable to treat infants with antibiotics. Antibiotic therapy with macrolides or cephalosporins is advisable only in children with confirmed sepsis.

In all other cases, antibiotics destroy the intestinal microflora, and staphylococcus safely continues its existence and enterocolitis flares up even more, since the pathogenic flora no longer experiences competition from bifidum and lactobacilli.

Probiotics in this case do not help, because against the background of taking antibiotics, the beneficial flora does not take root, besides, staphylococci or Klebsiella quickly destroy the incoming negligible number of beneficial bacteria.

It is most reasonable to treat with specialized bacteriophages - viruses that devour a certain type of bacteria:

• Staphylococcus bacteriophage is used in pure form or in the form of a complex (a mixture of phages of staphylococcus, salmonella, shigella, etc.);
• Duration of bacteriophage intake - 1-2 weeks;
• In the absence of a therapeutic effect, a second course of treatment is carried out;
• The drug requires special storage conditions. Temperature - no higher than 6 ° C. This means that it can only be stored in the refrigerator. For direct use, the drug should be brought to room temperature. You cannot heat it. This is the main difficulty in using.

The following medicines are used to fight bacteria:

• Nitrofurans. Stopdiar, Ersefuril, Enterofuril. Their use is allowed starting from the month from birth. The drugs are effective against both staphylococci and Klebsiella. Duration of admission is 7 days. Furazolidone is recommended for children over one year old;
• Enterosorbents. Should be used with great caution as there is a high risk of intestinal intussusception. Reception of Smecta is recommended;
• Immunostimulants. For use in infants, Kipferon is recommended. The course of treatment is 5 days;
• Probiotic preparations. Used to restore normal intestinal microflora. Specific names should be selected based on the general health of the child;
• Complex therapy is used to restore the water-salt balance. It is almost impossible to restore the balance on your own. Between feedings, the child must be given clean water at the rate of 100 ml of water for each kilogram of weight. After improving the general condition, they switch to maintenance supplementation. The volume of water is 100 ml for each kilogram of weight per day. This means that a child weighing 4 kg should receive 400 ml of water per day.

To stop vomiting, cerucal is injected intramuscularly. Together with him, they continue to receive fluid. Every 4-10 minutes - a teaspoon of water. Solutions of hydralazine and rehydron are introduced, as well as 5% glucose in a 1: 4 ratio. If this method of restoring the water-salt balance was ineffective and symptoms of dehydration are observed, the only way is hospitalization and intravenous fluids.

Prevention of staphylococcus in infants

Staphylococcus aureus is everywhere. It is impossible to protect a child from this bacteria. However, with sufficient functioning of the immune system and timely treatment of staphylococcal infection, this is not a problem. According to statistics, almost 100% of the world's population are carriers of Staphylococcus aureus in a depressed state.

However, the risk of infection should be minimized in the first months of a child's life.

For this it is recommended:

• Correctly disinfect household and feeding items: bottles, nipples should be processed in sterilizers, and in their absence - boiled;
• Eliminate contacts with public toys. In the clinic, hospital, toys should be their own;
• Nipples that fall on any surface must be sent for sterilization;
• The room in which the child is located must be regularly ventilated;
• Wet cleaning of the room should be carried out as often as possible. Staphylococcus aureus feels great on dust particles.

Thus, staphylococcal infection is one of the most dangerous and formidable. Staphylococcus aureus is the causative agent of many dangerous inflammatory diseases. Children under one year of age, especially infants, whose immunity is not yet sufficiently effective, are most severely infected.

Most often, Staphylococcus aureus affects the mucous membranes of the intestines and stomach, which causes the development of severe gastroenterocolitis.

Diagnosis of diseases caused by Staphylococcus aureus is not particularly difficult. It is much more difficult to find the optimal and safe treatment for the child. Antibiotic therapy is indicated in a strictly limited number of cases; the use of bacteriophages is more effective and safer. In general, the therapy should be comprehensive.

Klebsiella is less aggressive, and only causes infectious lesions in weakened children. Often, the bacterium coexists peacefully with Staphylococcus aureus. Both manifestations and methods of treatment of Klebsiella infections are similar to the fight against staphylococcus.

It is desirable that the child in the first months of life does not meet with such dangerous pathogens, therefore, special attention should be paid to preventive measures.

The author of the article: Sokolova Praskovya Fedorovna | Pediatrician

Education: Diploma in the specialty "General Medicine" received at the Volgograd State Medical University. A specialist certificate was immediately received in 2014.