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耐甲氧西林金黄色葡萄球菌肺炎的治疗。

Management of methicillin-resistant Staphylococcus aureus pneumonia.

机构信息

Department of Medicine, Pulmonary Division, Hospital de Clínicas, Universidad de Buenos Aires, Argentina.

出版信息

Curr Opin Infect Dis. 2010 Apr;23(2):178-84. doi: 10.1097/QCO.0b013e328336a23f.

Abstract

PURPOSE OF REVIEW

Staphylococcus aureus, and particularly methicillin-resistant Staphylococcus aureus (MRSA) has become an increasingly important etiology of pneumonia, both in healthcare and community settings. Associated with highest morbidity, mortality and costs in public health, it represents a major challenge for the management of this group of patients.

RECENT FINDINGS

MRSA is one of the most common pathogens of ventilator associated pneumonia, whereas its estimated incidence for hospital acquired pneumonia, healthcare associated pneumonia and community acquired pneumonia has risen in the past decades. Although vancomycin at standard doses remains as the mainstay for its treatment, the increasing rate of treatment failure has prompted other strategies of use (more frequent administration, continuous infusion, combination therapy), and the use of newer antimicrobials, particularly linezolid, with pharmacokinetic and pharmacodynamic profiles which produce promisingly improved clinical results.

SUMMARY

Overall, MRSA is an important cause of pneumonia; optimal management strategies for improving morbidity and mortality are still under development.

摘要

目的综述

金黄色葡萄球菌,尤其是耐甲氧西林金黄色葡萄球菌(MRSA)已成为医院和社区环境中肺炎日益重要的病因。其与发病率、死亡率和公共卫生成本最高相关,这对这类患者的治疗构成了重大挑战。

最近的发现

MRSA 是呼吸机相关性肺炎最常见的病原体之一,而其在医院获得性肺炎、医疗保健相关性肺炎和社区获得性肺炎中的估计发病率在过去几十年中有所上升。虽然标准剂量的万古霉素仍然是其治疗的主要药物,但治疗失败率的上升促使人们采用其他使用策略(更频繁的给药、连续输注、联合治疗),并使用新型抗菌药物,特别是具有有前景的改善临床结果的药代动力学和药效学特征的利奈唑胺。

总之,MRSA 是肺炎的重要病因;仍在开发改善发病率和死亡率的最佳治疗策略。

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