Duke University Medical Center, Durham, NC, USA.
Division of Infectious Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Nat Rev Microbiol. 2019 Apr;17(4):203-218. doi: 10.1038/s41579-018-0147-4.
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most successful modern pathogens. The same organism that lives as a commensal and is transmitted in both health-care and community settings is also a leading cause of bacteraemia, endocarditis, skin and soft tissue infections, bone and joint infections and hospital-acquired infections. Genetically diverse, the epidemiology of MRSA is primarily characterized by the serial emergence of epidemic strains. Although its incidence has recently declined in some regions, MRSA still poses a formidable clinical threat, with persistently high morbidity and mortality. Successful treatment remains challenging and requires the evaluation of both novel antimicrobials and adjunctive aspects of care, such as infectious disease consultation, echocardiography and source control. In this Review, we provide an overview of basic and clinical MRSA research and summarize the expansive body of literature on the epidemiology, transmission, genetic diversity, evolution, surveillance and treatment of MRSA.
耐甲氧西林金黄色葡萄球菌(MRSA)是最成功的现代病原体之一。这种既能在卫生保健和社区环境中作为共生菌传播,又能导致菌血症、心内膜炎、皮肤和软组织感染、骨和关节感染以及医院获得性感染的病原体,其遗传多样性使其成为主要特征的是流行株的连续出现。尽管 MRSA 的发病率在最近一些地区有所下降,但它仍然是一个严峻的临床威胁,其发病率和死亡率持续居高不下。成功的治疗仍然具有挑战性,需要评估新型抗菌药物和护理辅助方面,如传染病咨询、超声心动图和源头控制。在本综述中,我们提供了关于 MRSA 的基础和临床研究的概述,并总结了关于 MRSA 的流行病学、传播、遗传多样性、进化、监测和治疗的广泛文献。