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金黄色葡萄球菌感染:流行病学、病理生理学、临床表现及管理

Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management.

作者信息

Tong Steven Y C, Davis Joshua S, Eichenberger Emily, Holland Thomas L, Fowler Vance G

机构信息

Global and Tropical Health, Menzies School of Health Research, Darwin, Northern Territory, Australia

Global and Tropical Health, Menzies School of Health Research, Darwin, Northern Territory, Australia.

出版信息

Clin Microbiol Rev. 2015 Jul;28(3):603-61. doi: 10.1128/CMR.00134-14.

Abstract

Staphylococcus aureus is a major human pathogen that causes a wide range of clinical infections. It is a leading cause of bacteremia and infective endocarditis as well as osteoarticular, skin and soft tissue, pleuropulmonary, and device-related infections. This review comprehensively covers the epidemiology, pathophysiology, clinical manifestations, and management of each of these clinical entities. The past 2 decades have witnessed two clear shifts in the epidemiology of S. aureus infections: first, a growing number of health care-associated infections, particularly seen in infective endocarditis and prosthetic device infections, and second, an epidemic of community-associated skin and soft tissue infections driven by strains with certain virulence factors and resistance to β-lactam antibiotics. In reviewing the literature to support management strategies for these clinical manifestations, we also highlight the paucity of high-quality evidence for many key clinical questions.

摘要

金黄色葡萄球菌是一种主要的人类病原体,可引起多种临床感染。它是菌血症、感染性心内膜炎以及骨关节炎、皮肤和软组织、胸膜肺部及与器械相关感染的主要病因。本综述全面涵盖了这些临床病症各自的流行病学、病理生理学、临床表现及管理。过去20年见证了金黄色葡萄球菌感染流行病学的两个明显转变:第一,与医疗保健相关的感染越来越多,尤其是在感染性心内膜炎和人工器械感染中;第二,由具有某些毒力因子且对β-内酰胺抗生素耐药的菌株引发的社区相关性皮肤和软组织感染的流行。在回顾支持这些临床表现管理策略的文献时,我们还强调了许多关键临床问题缺乏高质量证据的情况。

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