Faculté de Médecine, Université de Nantes, Laboratoire UPRES EA 3826, 1 rue Gaston Veil, 44035, Nantes Cedex, France,
Curr Infect Dis Rep. 2013 Aug;15(4):329-34. doi: 10.1007/s11908-013-0349-x.
Infective endocarditis is a worrisome disease, with no significant decrease of the incidence and mortality in the last decade. Despite a changing epidemiology over the last few years, S. aureus remains the leading causative organism in Canada, the U.S., and Europe. Experimental animal models of endocarditis have been extensively used to evaluate the activity of new drugs or new regimens. Although vancomycin has shown satisfactory in vivo activity against MRSA, the drug has failed to demonstrate a bactericidal activity against isolates with reduced susceptibility to glycopeptides. Among the new, recently available antimicrobial agents, experimental data strongly support daptomycin and ceftaroline fosamil as effective options. In clinical practice, vancomycin continues to be recommended for the treatment of IE caused by MRSA. However, its use is more and more debated, especially with the availability of new effective therapeutic options. Further studies are needed to define the role of these new antimicrobials in the treatment of MRSA and GISA endocarditis.
感染性心内膜炎是一种令人担忧的疾病，在过去十年中，其发病率和死亡率并没有显著下降。尽管近年来流行病学发生了变化，但金黄色葡萄球菌仍然是加拿大、美国和欧洲的主要致病病原体。感染性心内膜炎的实验动物模型已被广泛用于评估新药或新方案的活性。尽管万古霉素对耐甲氧西林金黄色葡萄球菌 (MRSA) 具有令人满意的体内活性，但该药物未能显示对糖肽类药物敏感性降低的分离株具有杀菌活性。在新的、最近可用的抗菌药物中，实验数据强烈支持达托霉素和头孢洛林酯作为有效的选择。在临床实践中，万古霉素继续被推荐用于治疗由耐甲氧西林金黄色葡萄球菌引起的 IE。然而，随着新的有效治疗选择的出现，其使用越来越受到争议。需要进一步的研究来确定这些新的抗菌药物在治疗耐甲氧西林金黄色葡萄球菌和万古霉素中介金黄色葡萄球菌心内膜炎中的作用。
