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Staphylococcus aureus is a gram-positive coccus. It is part of the microbiota of the human body usually found on the skin or upper respiratory tract. It is usually commensal but may cause opportunistic infections such as skin infections commonly or less frequently, pneumonia and endocarditis. It can cause both community and hospital-acquired pneumonia. Hospital-acquired Staph pneumonia is most commonly associated with intubation and prolonged admissions. Prevalence of hospital acquired pneumonia caused by MethicillinResistant Staph Aureus (MRSA) is increasing.
It is an important cause of secondary bacterial pneumonia in patients following viral respiratory infection e.g. post influenza infection. Intravenous drug users have an increased risk of developing ‘metastatic’ Staph. aureus pneumonia and endocarditis, as a result of staph bacteraemia caused by the use of dirty needles. Staph. aureus pneumonia is severe and associated with an increased rate of complications, such as ca vitating abscess formation and empyema.
Staph Aureus pneumonia should be suspected in any of the highrisk groups above as well as patients with pneumonia with rapid deterioration, haemoptysis, early multilobar pneumonia on X-ray, pulmonary cavitation or disseminated intravascular coagulation. First line treatment for Staph. aureus pneumonia is penicillin antibiotics, such as flucloxacillin. Staph aureus resistance to penicillin is very common with penicillinase production e.g MRSA. MRSA is treated with glycopeptide antibiotics, such as vancomycin, or oxazolidinone antibiotics, such as linezolid.
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