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一名入住重症监护病房的患者发生耐甲氧西林金黄色葡萄球菌社区获得性肺炎:一项治疗挑战

Community-acquired Pneumonia with Methicillin-resistant Staphylococcus Aureus in a Patient Admitted to the Intensive Care Unit: A Therapeutic Challenge.

作者信息

Pham John, Asif Talal, Hamarshi Majdi S

机构信息

Department of Internal Medicine, University of Missouri Kansas City (UMKC).

Department of Critical Care Medicine, Saint Lukes Hospital, University of Missouri Kansas City (UMKC).

出版信息

Cureus. 2018 Jan 3;10(1):e2019. doi: 10.7759/cureus.2019.

Abstract

Methicillin-resistant S (MRSA) was previously considered a purely nosocomial pathogen. However, community-acquired MRSA has recently emerged as an important cause of severe necrotizing community-acquired pneumonia (CA-MRSA) in previously healthy individuals. This new pathogen exhibits antibiotic resistance and is linked to extended hospital stay and higher mortality. CA-MRSA has presented new therapeutic challenges due to high vancomycin treatment failure and lack of specificity of clinical findings. There is emerging evidence that treatment with linezolid leads to better patient outcomes in patients with CA-MRSA. Through this case, we aim to raise awareness about early institution of therapy for CA-MRSA whenever it is suspected, to improve patient outcomes.

摘要

耐甲氧西林金黄色葡萄球菌(MRSA)曾被认为是一种纯粹的医院病原体。然而,社区获得性MRSA最近已成为先前健康个体发生严重坏死性社区获得性肺炎(CA-MRSA)的重要原因。这种新病原体具有抗生素耐药性,并与住院时间延长和死亡率升高有关。由于万古霉素治疗失败率高且临床发现缺乏特异性,CA-MRSA带来了新的治疗挑战。越来越多的证据表明,利奈唑胺治疗可使CA-MRSA患者获得更好的治疗效果。通过本病例,我们旨在提高对疑似CA-MRSA时尽早开始治疗的认识,以改善患者治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/048f/5837304/28048e62b36d/cureus-0010-00000002019-i01.jpg

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