French G L, Cheng A F, Ling J M, Mo P, Donnan S
Department of Microbiology, Chinese University of Hong Kong, Shatin.
J Hosp Infect. 1990 Feb;15(2):117-25. doi: 10.1016/0195-6701(90)90120-d.
While most authorities agree that methicillin-resistant Staphylococcus aureus (MRSA) are as pathogenic as methicillin-sensitive strains (MSSA), some believe that MRSA are relatively avirulent opportunists, and that their importance has been exaggerated. We present evidence that Hong Kong strains of MRSA and MSSA are equally pathogenic: they have similar virulence in animal models; they are isolated in similar proportions from both deep and superficial clinical sites including blood; in patients with hospital-acquired bacteraemias mortality rates are similar when adjusted for clinical factors; and in both animals and patients with systemic MRSA infection, mortality rates are significantly reduced by vancomycin therapy. Efforts to control the spread of MRSA are justified, and in invasive sepsis early treatment with vancomycin may be life-saving.
虽然大多数权威人士认为耐甲氧西林金黄色葡萄球菌(MRSA)与甲氧西林敏感菌株(MSSA)的致病性相同,但一些人认为MRSA是相对无毒力的机会致病菌,其重要性被夸大了。我们提供的证据表明,香港的MRSA菌株和MSSA菌株致病性相同:它们在动物模型中具有相似的毒力;从包括血液在内的深部和浅表临床部位分离出的比例相似;在医院获得性菌血症患者中,经临床因素调整后死亡率相似;在患有全身性MRSA感染的动物和患者中,万古霉素治疗可显著降低死亡率。控制MRSA传播的努力是合理的,在侵袭性脓毒症中,早期用万古霉素治疗可能挽救生命。