Methicillin-resistant Staphylococcus aureus enterocolitis associated with antibiotic use
a literature review
DOI:
https://doi.org/10.47385/cadunifoa.v21.n56.5900Keywords:
Diarrhea, Enterocolitis, Staphylococcus aureus, Methicillin-Resistant Staphylococcus aureus, AntibioticsAbstract
Introduction: Antibiotic use is associated with intestinal dysbiosis, facilitating the expansion of opportunistic pathogens and the emergence of infectious enterocolitis. Although Clostridium difficile is the main recognized etiological agent, Staphylococcus aureus, especially methicillin-resistant Staphylococcus aureus (MRSA), has been reported as an underdiagnosed cause of antibiotic-associated diarrhea. Objective: To review the main epidemiological, pathophysiological, clinical, and diagnostic aspects of staphylococcal enterocolitis, especially MRSA infections. Methods: Literature review based on articles indexed in the PubMed database addressing intestinal colonization and enterocolitis associated with Staphylococcus aureus and their relationship with antibiotic use. Discussion: The destruction of the intestinal microbiota by antibiotics allows the overgrowth of Staphylococcus aureus, resulting in enterotoxin-mediated inflammation. MRSA can persist in the intestine after the end of antibiotic therapy, constituting an important hospital reservoir. Clinically, staphylococcal enterocolitis is characterized by large-volume watery diarrhea, fever, and histological findings of loosely adherent pseudomembranes in the small intestine. Stool culture is indicated for diagnosis, especially when the Clostridium difficile test is negative. Oral vancomycin has been the treatment of choice, with a significant reduction in mortality over the past few decades. Conclusion: MRSA enterocolitis, although uncommon, should be considered in the differential diagnosis of antibiotic-associated diarrhea, particularly when Clostridium difficile tests are negative.
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