Wertheim Heiman F L, Melles Damian C, Vos Margreet C, van Leeuwen Willem, van Belkum Alex, Verbrugh Henri A, Nouwen Jan L
Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands.
Lancet Infect Dis. 2005 Dec;5(12):751-62. doi: 10.1016/S1473-3099(05)70295-4.
Staphylococcus aureus is a frequent cause of infections in both the community and hospital. Worldwide, the increasing resistance of this pathogen to various antibiotics complicates treatment of S aureus infections. Effective measures to prevent S aureus infections are therefore urgently needed. It has been shown that nasal carriers of S aureus have an increased risk of acquiring an infection with this pathogen. The nose is the main ecological niche where S aureus resides in human beings, but the determinants of the carrier state are incompletely understood. Eradication of S aureus from nasal carriers prevents infection in specific patient categories-eg, haemodialysis and general surgery patients. However, recent randomised clinical trials in orthopaedic and non-surgical patients failed to show the efficacy of eliminating S aureus from the nose to prevent subsequent infection. Thus we must elucidate the mechanisms behind S aureus nasal carriage and infection to be able to develop new preventive strategies. We present an overview of the current knowledge of the determinants (both human and bacterial) and risks of S aureus nasal carriage. Studies on the population dynamics of S aureus are also summarised.
金黄色葡萄球菌是社区和医院感染的常见病因。在全球范围内，这种病原体对各种抗生素的耐药性不断增加，使得金黄色葡萄球菌感染的治疗变得复杂。因此，迫切需要有效的措施来预防金黄色葡萄球菌感染。已表明，金黄色葡萄球菌的鼻腔携带者感染这种病原体的风险增加。鼻子是金黄色葡萄球菌在人类体内的主要生态位，但携带者状态的决定因素尚不完全清楚。从鼻腔携带者中根除金黄色葡萄球菌可预防特定患者群体（如血液透析和普通外科手术患者）的感染。然而，最近在骨科和非手术患者中进行的随机临床试验未能显示从鼻腔清除金黄色葡萄球菌以预防后续感染的有效性。因此，我们必须阐明金黄色葡萄球菌鼻腔携带和感染背后的机制，以便能够制定新的预防策略。我们概述了目前关于金黄色葡萄球菌鼻腔携带的决定因素（包括人类和细菌因素）及风险的知识。还总结了关于金黄色葡萄球菌种群动态的研究。
