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社区获得性手部感染中耐甲氧西林金黄色葡萄球菌的发病率。

The incidence of methicillin-resistant staphylococcus aureus in community-acquired hand infections.

作者信息

Wilson Patrick C, Rinker Brian

机构信息

Division of Plastic Surgery, University of Kentucky College of Medicine, K454 Lexington, KY 40536, USA.

出版信息

Ann Plast Surg. 2009 May;62(5):513-6. doi: 10.1097/SAP.0b013e31818a6665.

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) has become increasingly prevalent in hand infections. Traditionally, the empiric treatment of hand infections has involved beta-lactam antibiotics, which are ineffective against MRSA. Centers for Disease Control recommends empiric coverage of MRSA infections if the local rate of MRSA exceeds 10% to 15%. A retrospective review was performed on all patients admitted for community-acquired soft tissue infections of the hand between 2004 and 2007 at a single institution. The overall incidence of MRSA was 60%. The incidence of MRSA in healthy adults was 64%, healthy pediatric patients was 100%, immunocompromised patients was 45%, and diabetic patients was 20%. The current rates of MRSA would imply that all patients presenting with hand infections should be treated empirically for MRSA. Linezolid is the only oral antibiotic approved by the Food and Drug Administration for treating MRSA, but many studies have reported that trimethoprim-sulfamethoxazole is an effective antibiotic for outpatient treatment of MRSA.

摘要

耐甲氧西林金黄色葡萄球菌(MRSA)在手部感染中越来越普遍。传统上,手部感染的经验性治疗使用β-内酰胺类抗生素,但这些抗生素对MRSA无效。如果当地MRSA感染率超过10%至15%,疾病控制中心建议对MRSA感染进行经验性覆盖治疗。对2004年至2007年期间在一家机构因社区获得性手部软组织感染入院的所有患者进行了回顾性研究。MRSA的总体发病率为60%。健康成年人中MRSA的发病率为64%,健康儿科患者为100%,免疫功能低下患者为45%,糖尿病患者为20%。目前MRSA的发病率表明,所有出现手部感染的患者都应接受针对MRSA的经验性治疗。利奈唑胺是美国食品药品监督管理局批准用于治疗MRSA的唯一口服抗生素,但许多研究报告称,甲氧苄啶-磺胺甲恶唑是门诊治疗MRSA的有效抗生素。

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