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葡萄球菌骨髓炎:疾病进展、治疗挑战和未来方向。

Staphylococcal Osteomyelitis: Disease Progression, Treatment Challenges, and Future Directions.

机构信息

Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland.

Cardiovascular Infection Research Group, Irish Centre for Vascular Biology, Royal College of Surgeons in Ireland, Dublin, Ireland.

出版信息

Clin Microbiol Rev. 2018 Feb 14;31(2). doi: 10.1128/CMR.00084-17. Print 2018 Apr.

Abstract

Osteomyelitis is an inflammatory bone disease that is caused by an infecting microorganism and leads to progressive bone destruction and loss. The most common causative species are the usually commensal staphylococci, with and responsible for the majority of cases. Staphylococcal infections are becoming an increasing global concern, partially due to the resistance mechanisms developed by staphylococci to evade the host immune system and antibiotic treatment. In addition to the ability of staphylococci to withstand treatment, surgical intervention in an effort to remove necrotic and infected bone further exacerbates patient impairment. Despite the advances in current health care, osteomyelitis is now a major clinical challenge, with recurrent and persistent infections occurring in approximately 40% of patients. This review aims to provide information about staphylococcus-induced bone infection, covering the clinical presentation and diagnosis of osteomyelitis, pathophysiology and complications of osteomyelitis, and future avenues that are being explored to treat osteomyelitis.

摘要

骨髓炎是一种炎症性骨病,由感染微生物引起,导致进行性骨破坏和丧失。最常见的致病物种通常是共生葡萄球菌, 和 负责大多数病例。葡萄球菌感染是一个日益严重的全球问题,部分原因是葡萄球菌为了逃避宿主免疫系统和抗生素治疗而发展出的耐药机制。除了葡萄球菌能够耐受治疗之外,为了清除坏死和感染的骨而进行的手术干预也进一步加剧了患者的损伤。尽管目前的医疗保健取得了进展,但骨髓炎现在仍然是一个主要的临床挑战,大约 40%的患者会出现反复和持续的感染。本综述旨在提供关于金黄色葡萄球菌引起的骨感染的信息,涵盖骨髓炎的临床表现和诊断、骨髓炎的病理生理学和并发症,以及正在探索的治疗骨髓炎的未来途径。

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