Staphylococcus is a Cause of Prostatitis. Treatment of Staphylococcus

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Stoyanov
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Staphylococcus is a Cause of Prostatitis. Treatment of Staphylococcus

#1 Post by Stoyanov » 07 May 2018, 22:51

Staphylococcus is a globular (absolutely round or slightly elongated) bacterium, which is a representative of the normal flora, inhabiting the skin and mucous membranes of a human. Pathogenic forms of staphylococcus can cause staphylococcal infection.

The pathogenic effect of staphylococci is due to the production of:
• enzymes that destroy the tissues of the infected organism;
• toxins, hemolysins, which suppress the immune activity of cells;
• enterotoxins, which have a toxic effect.

Staphylococci well tolerate drying, but die when exposed to chloramine for 2 to 3 minutes, to 50% alcohol – for 10 minutes.

Types and Prevalence of Staphylococcus

In male babies, epidermal (usually inhabiting the skin) staphylococcus is detected in the scaphoid fossa (a small area in the initial/anterior part of the urethra, which borders the mucous of the balanus), just a few hours after birth. With deepening into the urethra, the number of bacteria decreases and at a distance of about 5 cm, the urethra is practically sterile. With age, the composition of the urethral bacterial population in men, unlike women, does not change, but is sensitive to other factors (some microorganisms “inhabit” the urethra permanently, while some others – for some time only). Also, unlike women, the urethral microflora of men is not responsible for any specific functions.

In addition to epidermal staphylococcus in men (according different data, it can be detected in 50 to 100% of episodes) in about 25% of cases saprophyte staphylococcus can be found. Neutral-alkaline environment of the male urethra is conducive to replication and development of the saprophyte staphylococcus.

Neither epidermal nor saprophytic staphylococci cause diseases, and therefore “treatment of staphylococcus” in this case is not required. Staphylococcus aureus proves to be more pathogenic is. In males, staphylococcus aureus can be found on the skin or scaphoid fossa of the urethra even in perfectly healthy individuals (detection rate is up to 5%). In this case, staphylococcus aureus may cause a number of pathologies under certain conditions, exemplified by non-gonococcal urethritis in men. This disease does not apply to sexually transmitted infections, and if a woman does not suffer bacterial vaginosis, she cannot get infected from a sexual partner.

In any case, staphylococcus in men does not need treatment, and doctors say jokingly, “it keeps well”; however therapy may be necessary when it comes to staphylococcal infection, that is, a disease caused by this microorganism.

In addition to staphylococci, the anterior urethral part of a healthy man can show:
• streptococci (viz., Streptococcus mitis) – with a prevalence of 25%;
• fecal enterococcus – 25%;
• Neisseria (Neisseria sp.) – 25%;
• Enterobacteria (Escherichia coli E. coli) – 25%;
• Proteus sp. – 25%
• Blue pus bacillus (Pseudomonas aeruginosa) – up to 5%;
• Corynebacteria – 25%;
• Bacteroides (Bacteroides sp.) – 25%

Causes of Staphylococcus Infection and Initiating Agents

Staphylococcal infection in men will result from replication of pathogenic forms of staphylococcus in the genitourinary tract of, which can lead to the development of a number of diseases, including:
• urethritis (inflammation of the urethra);
• prostatitis (inflammatory lesion of the prostate gland);
• cystitis (lesion of the bladder);
• pyelitis (pathology of the renal pelvis);
• pyelonephritis (inflammatory kidney disease);
• glomerulonephritis (lesions of renal glomeruli of an autoimmune-inflammatory nature) and others.

In men, the lower sections of the genitourinary tract are mostly affected. Staphylococcal urethritis can develop against a background of trichomonas/gonorrhea infection, upon mechanical or chemical irritation of the urethra. It is possible to get infected with pathogenic staphylococcus from a woman who has an inflammatory disease caused by a corresponding causative agent (e.g., colpitis, endocervicitis). Staphylococcal glomerulonephritis develop in patients who earlier had some other infection of a similar nature (pneumonia, enterocolitis, etc.).

Staphylococci, which are normally present on the mucous membrane of the male urethra, can cause the disease in exceptional cases only, for example:
• against the background of immunodeficiency caused by HIV;
• after prolonged antibiotic therapy;
• after a severe illness;
• against long-lasting fasting, etc.

Below are the factors that contribute to the development of the pathology:
• unprotected sex;
• anal sex;
• inadequate hygiene of the genitals;
• hypothermia, excessive loads, unhealthy lifestyle;
• chronic infectious-inflammatory pathologies;
• contact with infected household items and medical equipment, etc.

Symptoms of Staphylococcal Infection

Symptoms of staphylococcal infection are not specific and manifest depending on the localization of the lesion. A significant increase in temperature, the presence of general toxicity signs are uncharacteristic. So, urethritis, caused by staphylococcus, is accompanied by the following manifestations:
• redness, irritation, discomfort in the urethra;
• soreness with urination, increased urination ;
• discharge of different types.

Prostatitis has the following symptoms:
• tenderness, swelling of the testicles (either unilaterally or bilaterally);
• pain in the lower abdomen of a different nature and intensity;
• impaired urination (up to acute urinary retention);
• discharge, etc.

Also, as for similar diseases caused by other pathogens, the intensity of symptoms is determined by the nature of the process, acute or chronic. Chronic pathology can occur with minimal manifestations.

It is impossible to establish conclusively that the cause of the problem is staphylococcus from symptoms only, a full- diagnostic examination required.

Methods of Diagnostics

If an infection of the genitourinary organs caused by staphylococcus is suspected, the doctor may prescribe the following studies:
• general urine and blood tests;
• bacteriological examination of urine (urinalysis for pathogenic microflora), determination of the bacteria count and their sensitivity to antibiotics;
• urine analysis by PCR method ( abbreviation for “polymerase chain reaction”) to exclude gonorrhea, trichomonas, chlamydia nature of urethritis;
• smear from the urethral mucosa, sampling of the prostate secretion and examination with a light microscope;
• bacteriological culture (analysis of discharge in prostatitis and other pathologies, analysis of sperm)
• enzyme immunoassay (for the exclusion of syphilis, HIV infection, etc.);
• other in vitro diagnostic methods, as a rule, to exclude the non-staphylococcal cause of the disease, and instrumental (magnetic resonance and/or computer tomography, ultrasound of the prostate, etc.), to determine localization and severity of the lesion, and to exclude tumor pathologies, etc.

Treatment of Staphylococcus

Identification of staphylococcus in a urethral smear in a routine examination is an indication for therapy only if there is a corresponding disease (urethritis, etc.). In a healthy man, the carriage of staphylococcus does not require treatment. In some cases, for example, when a married couple plans pregnancies, when a staphylococcus is detected in a man, a doctor may prescribe therapy by local means (Bactroban, etc.).

In a situation where there are manifestations of staphylococcal infection, one has to resort to antibiotic therapy. Local remedies in this case are ineffective, but can be used additionally. Staphylococcus aureus often (but not always!) is resistant to ciprofloxacin, but sensitive to amoxicillin, clarithromycin and other agents.

Standard treatment regimens for uncomplicated urogenital infection due to saprophytic staphylococci include (if sensitivity is confirmed):
• Cephalexin 500 mg per os, several times a day for a week;
• Amoxicillin-Clavulanate (875-125 mg);
• Ciprofloxacin in dosages of 250 mg several times a day or 500 mg once for a prolonged regimen;
• Levofloxacin 250 mg.
For the complicated course of diseases, the following regimen can be used:
• Amoxicillin-Clavulanate (875-125 mg) up to two weeks;
• Ampicillin-Sulbactamum;
• Cephalexin 500 mg to two weeks;
• Cefazolinum, Ceftriaxone intravenously;
• Ciprofloxacin 500 mg or 1 g for the prolonged form – orally, 400 mg – intravenously, up to two weeks;
• Levofloxacin 750 mg.

Also, in the treatment of urogenital infection caused by saprophyte staphylococcus, apply Co-trimoxazole, Norfloxacin.

When selecting treatment, it would be perfect to preliminary determine the sensitivity of the pathogen to certain drugs.

If a diagnostic examination reveals the presence of other infectious agents, several antimicrobial agents of different groups, a combination of antibacterial and antifungal medicines may be prescribed simultaneously.

In addition to antibiotics in the treatment of staphylococcal chronic diseases of the urogenital tract, bacteriophages (staphylococcal bacteriophage) can be used, both topically, by administering through the urethra, and per os. Bacteriophages are special viruses that may affect cells of specific bacteria.
Performance of physiotherapy, massage (with prostatitis), enzyme preparations, immunomodulators (polyoxidonium, etc.), folk remedies (cranberry juice, decoctions of herbs) in the treatment of staphylococcal infection has not been clinically proven, although some patients note improvement when resorting to the same.

An additional problem is the so-called methicillin-resistant Staphylococcus aureus (aka Staphylococcus aureus with multiple drug resistance). This bacterium, as well as other staphylococci, can inhabit the urinary tract and is resistant to most commonly used antibiotics. With the compromised immunity, such a microorganism causes infectious diseases that are difficult to treat.

Complications

If not treated, long-lasting staphylococcal urethritis in men may cause:
• impotence;
• Staphylococcal prostatitis, etc.

There is a risk of spread of inflammation to the seminal tubercle (colliculitis), seminal vesicles (vesiculitis), epididymis (epididymitis), and the testis itself (orchitis, orchiepididymitis).

Serious complications of staphylococcal diseases, such as staphylococcal scalded skin syndrome, toxic shock, etc. are not characteristic for infections of the urogenital tract in men. In women, toxic staphylococcal shock rarely develops when using tampons during menstruation, vaginal contraceptives (diaphragms, caps, spermicide sponges).

Preventive Treatment of Staphylococcus

Since staphylococci are normal inhabitants of the human mucous and skin integuments, specific preventive measures are usually not required.

It is recommended:
• to observe carefully the rules of personal hygiene (daily hygienic procedures, change of underwear, etc.);
• to abstain from unsafe sex;
• cold water treatment, healthy diet, moderate physical activity;
• timely detection and elimination of foci of chronic infection.

To prevent toxin-related diseases, such as toxic staphylococcal shock, people at risk of contamination (industrial and agricultural workers, frequent injuries, etc.), etc., can use staphylococcal anatoxin,

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