OVERVIEW
Staphylococcus epidermidis (SE) is one of the coagulase-negative staphylococci that can cause pneumonia. It can cause bacteremia combined with endocarditis, osteomyelitis, and septic arthritis. Coagulase-negative staphylococci (CNS) are commonly known as SE. CNS (mainly SE) was considered a pathogenic organism in the 1970s with only a few case reports, but in the 1980s it became one of the five most common diseases, with a prevalence of infection of about 9%, and it can lead to bacteremia, prosthetic valve endocarditis, urinary tract infections osteomyelitis, septic arthritis, and a wide variety of foreign body infections.
Etiology
Most of the disease is caused by nosocomial infections, which occur in the elderly with underlying diseases, especially patients with bronchiectasis, chronic obstructive pulmonary disease (COPD), diabetes mellitus and malignant tumors, patients who receive artificial airways or mechanical ventilation, undergo major surgery, chemotherapy, radiotherapy, long-term corticosteroid therapy or a large number of patients with broad-spectrum antibiotics. Due to the imbalance of internal flora caused by the decline of systemic or local immune function of the respiratory tract, the conditionally pathogenic bacteria, including this bacterium, multiply in large quantities, coupled with the repeated application of various devices catheterization increases the chance of transmission, and these many factors are the reasons for the high incidence of this disease.
Symptoms
Staphylococcus epidermidis infection is mainly a respiratory tract infection, and its signs and symptoms have no obvious specificity compared with those of other bacterial pneumonias. Irregular fever is the most common fever, and bronchopneumonia is the most common chest X-ray manifestation, followed by alveolar pneumonia, and complications such as pneumothorax and exudative pleuritis are also more likely to occur. The disease may also develop migratory abscesses in its place.
Examination
1. Peripheral blood leukocytes >10×109/L.
2. Other auxiliary tests: percutaneous lung puncture or blood culture results can confirm the diagnosis. Chest imaging.
Diagnosis
Lower respiratory tract infection pathogens are determined by the same principle, and SE is no exception.SE is useful for diagnosis if it is pure culture or the same strain on 2 occasions. However, because of the lack of specificity in the presentation of pneumonia caused by SE and the presence of mixed infections, caution should be exercised in determining a positive SE culture.
Treatment
Bacteriologic culture results confirm the disease preferred vancomycin, ticoranin or rifanilamide treatment, followed by rifampicin, imipenem, etc. also have a certain degree of sensitivity, SE has different degrees of resistance to other clinical antimicrobial agents, the resistance rate is as high as 11% to 100%, so the treatment should be preferred to glycopeptides or oxazolone, quinolones, glycosaminoglycans, rifampicin, etc., and at the same time, according to the characteristics of the disease. Timely review of pathogenesis, such as sputum, blood, pleural fluid and lower respiratory tract bacteriological culture and drug sensitivity test, according to the degree of its resistance to adjust the antibiotic varieties and dosage, and at the same time strengthen the supportive symptomatic treatment to improve the prognosis.