Petti Cathy A, Fowler Vance G
Departments of Pathology and Medicine, Box 3879, Duke University Medical Center, Durham, NC 27710, USA.
Infect Dis Clin North Am. 2002 Jun;16(2):413-35, x-xi. doi: 10.1016/s0891-5520(01)00003-4.
Staphylococcus aureus is a leading cause of bacteremia and endocarditis. Over the past several years, the frequency of S. aureus bacteremia (SAB) has increased dramatically. This increasing frequency, coupled with increasing rates of antibiotic resistance, has renewed interest in this serious, common infection. S. aureus is a unique pathogen because of its virulent properties, its protean manifestations, and its ability to cause endocarditis on architecturally normal cardiac valves. Although the possibility of underlying endocarditis arises in virtually every patient with SAB, only a minority of bacteremic patients will actually have cardiac involvement. Distinguishing patients with S. aureus infective endocarditis (IE) from those with uncomplicated SAB is essential, but often difficult. In this review, the authors summarize recent changes in the epidemiology of SAB and IE, discuss the challenges in distinguishing SAB from IE, and discuss current trends in the management of patients with SAB and IE.
金黄色葡萄球菌是菌血症和心内膜炎的主要病因。在过去几年中，金黄色葡萄球菌菌血症（SAB）的发生率急剧上升。这种发生率的增加，再加上抗生素耐药率的上升，使得人们对这种严重的常见感染重新产生了兴趣。金黄色葡萄球菌是一种独特的病原体，因其具有毒力特性、多样的临床表现以及在结构正常的心脏瓣膜上引发心内膜炎的能力。尽管几乎每位SAB患者都存在潜在的心内膜炎可能性，但实际上只有少数菌血症患者会出现心脏受累。区分金黄色葡萄球菌感染性心内膜炎（IE）患者与单纯SAB患者至关重要，但往往很困难。在这篇综述中，作者总结了SAB和IE流行病学的近期变化，讨论了区分SAB与IE的挑战，并探讨了SAB和IE患者管理的当前趋势。
