van den Broek P J
Leids Universitair Medisch Centrum, afd. Infectieziekten, Postbus 9600, 2300 RC Leiden.
Ned Tijdschr Geneeskd. 2003 May 31;147(22):1045-8.
Staphylococcus aureus is a dreadful pathogen for mankind, causing boils, abscesses, wound infections, osteomyelitis, septicaemia, endocarditis, pneumonia, toxic shock syndrome, scalded skin syndrome, and food poisoning. The development of penicillin-, methicillin-, and vancomycin-resistant strains shows that S. aureus has an enormous adaptive power. Most methicillin-resistant strains of S. aureus (MRSA) are hospital-acquired, although an increasing number are reported to be community-acquired. A limited number of clones of MRSA have spread all over the world. Since most community-acquired MRSA can be traced back to some contact with health care, MRSA can still best be combatted by control measures in health care institutions. In this respect, the Netherlands and Scandinavian countries have been very successful so far. S. aureus has many virulence factors at its disposal: structural components, enzymes and three types of toxins. Panton-Valentine leukocidin (PVL) has received attention as a factor causing severe pneumonia with high mortality. A strain combining methicillin resistance and PVL has spread through France. Recently, the genome of an MRSA strain has been unravelled. Its structure illustrates how well S. aureus can adapt itself and acquire properties of other microorganisms. This genetic knowledge may lead to new strategies to combat S. aureus.
金黄色葡萄球菌是人类的一种可怕病原体，可引起疖、脓肿、伤口感染、骨髓炎、败血症、心内膜炎、肺炎、中毒性休克综合征、烫伤样皮肤综合征和食物中毒。耐青霉素、耐甲氧西林和耐万古霉素菌株的出现表明金黄色葡萄球菌具有巨大的适应能力。大多数耐甲氧西林金黄色葡萄球菌（MRSA）菌株是医院获得性的，不过据报道社区获得性的数量也在增加。有限数量的MRSA克隆已传播至全球。由于大多数社区获得性MRSA可追溯到与医疗保健的某种接触，因此通过医疗机构的控制措施仍能最好地对抗MRSA。在这方面，荷兰和斯堪的纳维亚国家迄今一直非常成功。金黄色葡萄球菌有许多毒力因子可供利用：结构成分、酶和三种毒素。杀白细胞素（PVL）作为导致严重肺炎且死亡率高的一个因素受到了关注。一种兼具耐甲氧西林和PVL的菌株已在法国传播。最近，一株MRSA菌株的基因组已被破解。其结构说明了金黄色葡萄球菌如何能够很好地自我适应并获得其他微生物的特性。这种遗传学知识可能会带来对抗金黄色葡萄球菌的新策略。
