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社区获得性耐甲氧西林金黄色葡萄球菌:老对手的新面貌?

Community-acquired methicillin-resistant Staphylococcus aureus: the new face of an old foe?

机构信息

Department of Microbiology, Health Sciences Centre, Faculty of Medicine, Kuwait University, Kuwait.

出版信息

Med Princ Pract. 2013;22 Suppl 1(Suppl 1):20-9. doi: 10.1159/000354201. Epub 2013 Sep 13.

Abstract

The burden of infections caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasing among different patient populations globally. As CA-MRSA has become established in healthcare facilities, the range of infections caused by them has also increased. Molecular characterization of CA-MRSA isolates obtained from different centers has revealed significant diversity in their genetic backgrounds. Although many CA-MRSA strains are still susceptible to non-β-lactam antibiotics, multiresistance to non-β-lactam agents has emerged in some clones, posing substantial problems for empirical and directed therapy of infections caused by these strains. Some CA-MRSA clones have acquired the capacity to spread locally and internationally. CA-MRSA belonging to ST80-MRSA-IV and ST30-MRSA-IV appear to be the dominant clones in the countries of the Gulf Cooperation Council (GCC). The emergence of pandemic CA-MRSA clones not only limits therapeutic options but also presents significant challenges for infection control. Continued monitoring of global epidemiology and emerging drug resistance data is critical for the effective management of these infections.

摘要

社区相关性耐甲氧西林金黄色葡萄球菌(CA-MRSA)引起的感染负担在全球不同患者群体中不断增加。随着 CA-MRSA 在医疗机构中的建立,其引起的感染范围也有所扩大。对不同中心获得的 CA-MRSA 分离株进行的分子特征分析显示,其遗传背景存在显著差异。尽管许多 CA-MRSA 菌株仍然对非β-内酰胺类抗生素敏感,但一些克隆已出现对非β-内酰胺类药物的多药耐药性,这给这些菌株引起的感染的经验性和靶向治疗带来了重大问题。一些 CA-MRSA 克隆已获得在局部和国际上传播的能力。属于 ST80-MRSA-IV 和 ST30-MRSA-IV 的 CA-MRSA 似乎是海湾合作委员会(GCC)国家的主要克隆。大流行 CA-MRSA 克隆的出现不仅限制了治疗选择,也对感染控制提出了重大挑战。持续监测全球流行病学和新出现的耐药数据对于有效管理这些感染至关重要。

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