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口服万古霉素治疗耐甲氧西林金黄色葡萄球菌(MRSA)小肠结肠炎1例罕见病例

A Rare Case of Methicillin-Resistant Staphylococcus aureus (MRSA) Enterocolitis Treated With Oral Vancomycin.

作者信息

Tagliaferri Ariana R, Elagami Mohamed, Melki Gabriel, Sultana Yasmeen, Mechineni Ashesha

机构信息

Internal Medicine, St. Joseph's Regional Medical Center, Paterson, USA.

Medicine, St. Joseph's Regional Medical Center, Paterson, USA.

出版信息

Cureus. 2021 Dec 3;13(12):e20143. doi: 10.7759/cureus.20143. eCollection 2021 Dec.

DOI:10.7759/cureus.20143
PMID:35003976
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8723774/
Abstract

Historically, methicillin-resistant Staphylococcus aureus (MRSA) was thought to be the primary pathogen in pseudomembranous enterocolitis associated with antibiotic use or recent abdominal surgery; however, was later identified as another more common pathogen. Since the eclipse of the workup of hospital-acquired diarrhea now utilizes nucleic acid amplification rather than stool cultures and longer includes the investigation of other less common pathogens. Consequently, the diagnosis of MRSA enterocolitis has faded. It is imperative to consider more sinister pathogens not routinely covered in laboratory testing as MRSA enterocolitis infections have been known to progress to severe systemic infections and thus the delay or misdiagnosis can result in inappropriate treatment, prolonged hospitalizations, sepsis and/or death. Herein we present a case of a patient who presented with laboratory diagnosed MRSA enterocolitis in the absence of recent abdominal surgery or antibiotic use and was successfully treated with oral vancomycin.

摘要

从历史上看,耐甲氧西林金黄色葡萄球菌(MRSA)曾被认为是与抗生素使用或近期腹部手术相关的伪膜性小肠结肠炎的主要病原体;然而,后来被确定为另一种更常见的病原体。自从医院获得性腹泻的检查方法不再使用粪便培养,而是采用核酸扩增,并且现在还包括对其他不太常见病原体的调查以来,MRSA小肠结肠炎的诊断已经淡化。由于已知MRSA小肠结肠炎感染会发展为严重的全身感染,因此必须考虑实验室检测中未常规涵盖的更危险的病原体,延误或误诊可能导致治疗不当、住院时间延长、败血症和/或死亡。在此,我们报告一例患者,该患者在近期未进行腹部手术或未使用抗生素的情况下,经实验室诊断为MRSA小肠结肠炎,并通过口服万古霉素成功治愈。