IMR Press / FBS / Volume 14 / Issue 1 / DOI: 10.31083/j.fbs1401001
Open Access Review
How we deal with Staphylococcus aureus (MSSA, MRSA) central nervous system infections
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1 Azienda Sanitaria Universitaria Giuliano Isontina ASUGI, Trieste University Hospital, 34149 Trieste, Italy
2 Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Pisa, 56124 Pisa, Italy
*Correspondence: niccolo.riccardi@yahoo.it (Niccolò Riccardi)
Academic Editor: Gustavo Caetano-Anollés
Front. Biosci. (Schol Ed) 2022, 14(1), 1; https://doi.org/10.31083/j.fbs1401001
Submitted: 21 November 2021 | Revised: 18 December 2021 | Accepted: 23 December 2021 | Published: 12 January 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Among central nervous system (CNS) infections (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. It has been estimated that SA is responsible for around 1%–7% of meningitis (up to 19% in healthcare-associated meningitis). Recent neurosurgical procedures and immunocompromisation are major risk factors for SA CNS infections. Hand hygiene, surveillance nasal swabs and perioperative prophylaxis are crucial points for effective SA infections 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. In this narrative review, we reviewed current literature to provide practical suggestions on diagnosis, prevention, management, and treatment of SA CNS infections.

Keywords
Staphylococcus aureus
Central nervous system
CNS
MSSA
MRSA
Management
Review
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