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耐甲氧西林金黄色葡萄球菌菌血症

MRSA bacteraemia.

作者信息

Gould Ian M

机构信息

Department of Medical Microbiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, UK.

出版信息

Int J Antimicrob Agents. 2007 Nov;30 Suppl 1:S66-70. doi: 10.1016/j.ijantimicag.2007.06.023. Epub 2007 Sep 17.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) has been pandemic for over a decade and is causing a major increase in serious staphylococcal infections. This is reflected in large increases in S. aureus bacteraemia with over 50% in many countries being caused by MRSA. Moreover, in some countries it also seems as though methicillin-susceptible S. aureus (MSSA) bacteraemia is also increasing. MRSA certainly has not replaced MSSA but is an additional burden with significantly higher mortality. Standard treatment of MRSA bacteraemia with glycopeptides is probably suboptimal in the presence of increasing resistance, MIC drift, uncertainties about laboratory susceptibility testing and fears of toxicity. New antibiotics look set to replace glycopeptides as the gold standard for treatment of MRSA bacteraemia, but whether the underlying causes of MRSA bacteraemia can be addressed successfully in order to control this pandemic disease is less certain.

摘要

耐甲氧西林金黄色葡萄球菌(MRSA)已经流行了十多年,并且正在导致严重葡萄球菌感染大幅增加。这体现在金黄色葡萄球菌菌血症大幅增加,在许多国家超过50%的病例由MRSA引起。此外,在一些国家,似乎甲氧西林敏感金黄色葡萄球菌(MSSA)菌血症也在增加。MRSA肯定没有取代MSSA,但却是一个额外负担,死亡率显著更高。在耐药性增加、最低抑菌浓度漂移、实验室药敏试验存在不确定性以及担心毒性的情况下,用糖肽类药物对MRSA菌血症进行标准治疗可能并不理想。新抗生素似乎将取代糖肽类药物成为治疗MRSA菌血症的金标准,但能否成功解决MRSA菌血症的根本原因以控制这种大流行疾病尚不确定。

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