====== Staphylococcus aureus ======

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[[Staphylococcus]] aureus is a [[Gram-positive bacteria]] that is a member of the Firmicutes, and is frequently found in the human [[respiratory tract]] and on the [[skin]]. It is positive for catalase and nitrate reduction. Although S. aureus is not always pathogenic, it is a common cause of [[skin infection]]s (e.g. boils), respiratory disease (e.g. [[sinusitis]]), and food poisoning. Disease-associated strains often promote infections by producing potent protein toxins, and expressing cell-surface proteins that bind and inactivate antibodies. 



===== Classification =====

see [[Methicillin resistant Staphylococcus aureus]].

see [[Methicillin sensitive Staphylococcus aureus]].

===== Epidemiology =====

The epidemiology of invasive of S. aureus infections continues to evolve with [[Methicillin sensitive Staphylococcus aureus]] (MSSA) accounting for most of the infections in the series of Vallejo et al.

The majority of cases were associated with neurosurgical procedures; however, hematogenous S. aureus meningitis and spinal epidural abscess (SEA) occurred as community-acquired infections in patients without predisposing factors. Patients with MRSA CNS infections had a favorable response to vancomycin, but the beneficial effect of combination therapy or targeting vancomycin trough concentrations of 15-20 μg/mL remains unclear
((Vallejo JG, Cain AN, Mason EO, Kaplan SL, Hultén KG. [[Staphylococcus aureus]]
[[Central Nervous System Infection]]s in [[Child]]ren. Pediatr Infect Dis J. 2017
Oct;36(10):947-951. doi: 10.1097/INF.0000000000001603. PubMed PMID: 28399057.
)).

===== Prevention =====

Neurosurgical [[procedure]]s and immunocompromisation are major [[risk factor]]s for [[Staphylococcus aureus]] [[central nervous system infection]]s. Hand [[hygiene]], [[surveillance]] nasal [[swab]]s and [[perioperative]] [[prophylaxis]] are crucial points for effective SA [[infection]]s [[prevention]]. In case of SA-CNS infections, pending microbiological results, anti-methicillin-resistant SA (MRSA) [[antibiotic]], with good CNS penetration, should be included, with prompt de-escalation as soon as [[MRSA]] is ruled out. Consultation with an expert in antimicrobial therapy is recommended as well as prompt source control when feasible
((Antonello RM, Riccardi N. How we deal with [[Staphylococcus aureus]] (MSSA, MRSA) [[central nervous system infection]]s. Front Biosci (Schol Ed). 2022 Jan 12;14(1):1. doi: 10.31083/j.fbs1401001. PMID: 35320912.)).

===== Treatment =====

[[Staphylococcus aureus treatment]].

===== Complications =====

[[Implant]] failure is a severe and frequent adverse event in all areas of neurosurgery. It often involves infection with [[biofilm]] formation, accompanied by [[inflammation]] of surrounding tissue, including the brain, and bone loss. The most common bacteria involved are [[Staphylococcus aureus]]. 

see [[Staphylococcus aureus brain abscess]].

see [[Hem coagulase-induced thrombotic events]].

===== Outcome =====
Among [[central nervous system infection]]s (e.g., [[meningitis]], [[brain abscess]], [[ventriculitis]], [[transverse myelitis]]), those caused by [[Staphylococcus aureus]] (SA) are particularly challenging both in management and treatment, with poor clinical outcomes and long [[hospital stay]]
((Antonello RM, Riccardi N. How we deal with [[Staphylococcus aureus]] (MSSA, MRSA) [[central nervous system infection]]s. Front Biosci (Schol Ed). 2022 Jan 12;14(1):1. doi: 10.31083/j.fbs1401001. PMID: 35320912.)).



===== Case series =====

[[Staphylococcus Aureus Case Series]].