Veterans Affairs Greater Los Angeles Healthcare System, CA, USA.
J Antimicrob Chemother. 2010 Jan;65(1):24-36. doi: 10.1093/jac/dkp377.
Invasive infections caused by methicillin-resistant Staphylococcus aureus (MRSA), particularly those involving persistent bacteraemia, necrotizing pneumonia, osteomyelitis and other deep-seated sites of infections, are associated with high mortality and are often difficult to treat. The response to treatment of severe MRSA infection with currently available antibiotics active against MRSA is often unsatisfactory, leading some physicians to resort to combination antibiotic therapy. Now, with the emergence of community-associated MRSA (CA-MRSA) clones that display enhanced virulence potentially related to up-regulated toxin production, the use of adjuvant protein synthesis-inhibiting antibiotics to reduce toxin production also has been advocated by some experts. In this review, we discuss the limitations of antibiotics currently available for the treatment of serious invasive MRSA infections and review the existing literature that examines the potential role of combination therapy in these infections.
耐甲氧西林金黄色葡萄球菌（MRSA）引起的侵袭性感染，特别是那些涉及持续性菌血症、坏死性肺炎、骨髓炎和其他深部感染部位的感染，与高死亡率相关，并且通常难以治疗。目前可用的抗 MRSA 抗生素治疗严重 MRSA 感染的反应往往不尽如人意，这导致一些医生采用联合抗生素治疗。现在，随着社区相关性 MRSA（CA-MRSA）克隆的出现，这些克隆显示出增强的毒力，可能与毒素产生的上调有关，一些专家也主张使用辅助蛋白合成抑制抗生素来减少毒素的产生。在这篇综述中，我们讨论了目前用于治疗严重侵袭性 MRSA 感染的抗生素的局限性，并回顾了现有的文献，这些文献探讨了联合治疗在这些感染中的潜在作用。
