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金黄色葡萄球菌菌血症:流行病学、病理生理学及管理策略

Staphylococcus aureus bacteremia: epidemiology, pathophysiology, and management strategies.

作者信息

Naber Christoph K

机构信息

Department of Cardiology, West-German Heart Center, Essen, Germany.

出版信息

Clin Infect Dis. 2009 May 15;48 Suppl 4:S231-7. doi: 10.1086/598189.

Abstract

Staphylococcus aureus is a major cause of bacteremia, and S. aureus bacteremia is associated with higher morbidity and mortality, compared with bacteremia caused by other pathogens. The burden of S. aureus bacteremia, particularly methicillin-resistant S. aureus bacteremia, in terms of cost and resource use is high. The risk of infective endocarditis and of seeding to other metastatic foci increases the risk of mortality and raises the stakes for early, appropriate treatment. The incidence of S. aureus bacteremia and its complications has increased sharply in recent years because of the increased frequency of invasive procedures, increased numbers of immunocompromised patients, and increased resistance of S. aureus strains to available antibiotics. This changing epidemiology of S. aureus bacteremia, in combination with the inherent virulence of the pathogen, is driving an urgent need for improved strategies and better antibiotics to prevent and treat S. aureus bacteremia and its complications.

摘要

金黄色葡萄球菌是菌血症的主要病因,与其他病原体引起的菌血症相比,金黄色葡萄球菌菌血症的发病率和死亡率更高。就成本和资源利用而言,金黄色葡萄球菌菌血症,尤其是耐甲氧西林金黄色葡萄球菌菌血症的负担很高。感染性心内膜炎和播散至其他转移灶的风险增加了死亡风险,并提高了早期适当治疗的重要性。近年来,由于侵入性操作频率增加、免疫功能低下患者数量增多以及金黄色葡萄球菌菌株对现有抗生素的耐药性增强,金黄色葡萄球菌菌血症及其并发症的发病率急剧上升。金黄色葡萄球菌菌血症这种不断变化的流行病学情况,加上该病原体固有的毒力,迫切需要改进预防和治疗金黄色葡萄球菌菌血症及其并发症的策略和更好的抗生素。

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