Gajdács Márió
Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, 6720 Szeged, Hungary.
Antibiotics (Basel). 2019 May 2;8(2):52. doi: 10.3390/antibiotics8020052.
Staphylococcus aureus has been an exceptionally successful pathogen, which is still relevant in modern age-medicine due to its adaptability and tenacity. This bacterium may be a causative agent in a plethora of infections, owing to its abundance (in the environment and in the normal flora) and the variety of virulence factors that it possesses. Methicillin-resistant S. aureus (MRSA) strains-first described in 1961-are characterized by an altered penicillin-binding protein (PBP2a/c) and resistance to all penicillins, cephalosporins, and carbapenems, which makes the β-lactam armamentarium clinically ineffective. The acquisition of additional resistance determinants further complicates their eradication; therefore, MRSA can be considered as the first representative of multidrug-resistant bacteria. Based on 230 references, the aim of this review is to recap the history, the emergence, and clinical features of various MRSA infections (hospital-, community-, and livestock-associated), and to summarize the current advances regarding MRSA screening, typing, and therapeutic options (including lipoglycopeptides, oxazolidinones, anti-MRSA cephalosporins, novel pleuromutilin-, tetracycline- and quinolone-derivatives, daptomycin, fusidic acid, in addition to drug candidates in the development phase), both for an audience of clinical microbiologists and infectious disease specialists.
金黄色葡萄球菌一直是一种极其成功的病原体,由于其适应性和顽强性,在现代医学中仍然具有重要意义。这种细菌可能是多种感染的病原体,这归因于其数量众多(在环境和正常菌群中)以及它所拥有的多种毒力因子。耐甲氧西林金黄色葡萄球菌(MRSA)菌株于1961年首次被描述,其特征是青霉素结合蛋白(PBP2a/c)发生改变,对所有青霉素、头孢菌素和碳青霉烯类药物耐药,这使得β-内酰胺类药物在临床上无效。获得额外的耐药决定因素进一步使它们的根除变得复杂;因此,MRSA可被视为多重耐药细菌的首个代表。基于230篇参考文献,本综述的目的是概述各种MRSA感染(医院相关、社区相关和家畜相关)的历史、出现情况和临床特征,并总结目前关于MRSA筛查、分型和治疗选择(包括脂糖肽类、恶唑烷酮类、抗MRSA头孢菌素、新型截短侧耳素、四环素和喹诺酮衍生物、达托霉素、夫西地酸,以及处于研发阶段的候选药物)的进展,供临床微生物学家和传染病专家阅读。