Infectious Diseases Fellowship Program, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA.
Clin Infect Dis. 2010 Sep 15;51 Suppl 2:S183-97. doi: 10.1086/653519.
Although first identified just >4 decades ago, methicillin-resistant Staphylococcus aureus (MRSA) has undergone rapid evolutionary changes and epidemiologic expansion to become a major cause of nosocomial and community-acquired infections worldwide. Increasing resistance to vancomycin among MRSA strains in conjunction with availability of new antibiotics, including daptomycin and linezolid, have increased treatment choices but made clinical treatment decisions more challenging. This article describes the clinical features and management issues of 2 challenging-to-treat manifestations of MRSA infection, bacteremia and/or endocarditis and osteomyelitis. It also presents a brief review of community-associated MRSA infections and preventive strategies directed against MRSA.
虽然耐甲氧西林金黄色葡萄球菌 (MRSA) 仅在 >40 年前才首次被发现，但它已经经历了快速的进化变化和流行病学扩张，成为全球医院内和社区获得性感染的主要原因。MRSA 菌株对万古霉素的耐药性不断增加，再加上新抗生素（包括达托霉素和利奈唑胺）的出现，增加了治疗选择，但也使临床治疗决策更加具有挑战性。本文描述了 2 种治疗困难的耐甲氧西林金黄色葡萄球菌感染表现，即菌血症和/或心内膜炎和骨髓炎的临床特征和管理问题。本文还简要回顾了社区相关性耐甲氧西林金黄色葡萄球菌感染和针对耐甲氧西林金黄色葡萄球菌的预防策略。
