Gudiol Francisco, Aguado José María, Pascual Alvaro, Pujol Miquel, Almirante Benito, Miró José María, Cercenado Emilia, Domínguez María de Los Angeles, Soriano Alex, Rodríguez-Baño Jesús, Vallés Jordi, Palomar Mercedes, Tornos Pilar, Bouza Emilio
Servicio de Enfermedades Infecciosas, IDIBELL, Hospital Universitario de Bellvitge, Barcelona, España.
Enferm Infecc Microbiol Clin. 2009 Feb;27(2):105-15. doi: 10.1016/j.eimc.2008.09.003. Epub 2009 Feb 11.
Bacteremia and endocarditis due to methicillin-resistant Staphylococcus aureus (MRSA) are prevalent and clinically important. The rise in MRSA bacteremia and endocarditis is related with the increasing use of venous catheters and other vascular procedures. Glycopeptides have been the reference drugs for treating these infections. Unfortunately their activity is not completely satisfactory, particularly against MRSA strains with MICs > 1 microg/mL. The development of new antibiotics, such as linezolid and daptomycin, and the promise of future compounds (dalvabancin, ceftobiprole and telavancin) may change the expectatives in this field.The principal aim of this consensus document was to formulate several recommendations to improve the outcome of MRSA bacteremia and endocarditis, based on the latest reported scientific evidence. This document specifically analyzes the approach for three clinical situations: venous catheter-related bacteremia, persistent bacteremia, and infective endocarditis due to MRSA.
耐甲氧西林金黄色葡萄球菌（MRSA）引起的菌血症和心内膜炎很常见且具有临床重要性。MRSA菌血症和心内膜炎的增加与静脉导管及其他血管介入操作的使用增多有关。糖肽类药物一直是治疗这些感染的参考药物。不幸的是，它们的活性并不完全令人满意，特别是对于最低抑菌浓度（MIC）>1μg/mL的MRSA菌株。新型抗生素如利奈唑胺和达托霉素的出现，以及未来化合物（达巴万星、头孢比普和替拉万星）的前景，可能会改变该领域的预期。本共识文件的主要目的是根据最新报道的科学证据，制定若干建议以改善MRSA菌血症和心内膜炎的治疗结果。本文档具体分析了三种临床情况的处理方法：静脉导管相关菌血症、持续性菌血症以及由MRSA引起的感染性心内膜炎。
