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2019 年冠状病毒病患者耐甲氧西林金黄色葡萄球菌肺部感染:有多常见?

Methicillin-resistant Staphylococcus aureus lung infection in coronavirus disease 2019: how common?

机构信息

Infectious Diseases Unit, San Martino Policlinico Hospital - IRCCS.

Department of Health Sciences, University of Genoa, Genoa, Italy.

出版信息

Curr Opin Infect Dis. 2022 Apr 1;35(2):149-162. doi: 10.1097/QCO.0000000000000813.

Abstract

PURPOSE OF REVIEW

Some patients with coronavirus disease 2019 (COVID-19) may develop pulmonary bacterial coinfection or superinfection, that could unfavorably impact their prognosis.

RECENT FINDINGS

The exact burden of methicillin-resistant Staphylococcus aureus (MRSA) lung infection in peculiar populations such as patients with COVID-19 remains somewhat elusive, possibly because of wide heterogeneity in methods and endpoints across studies.

SUMMARY

There was important heterogeneity in the retrieved literature on the epidemiology of MRSA lung infection in patients with COVID-19, both when considering all other bacteria as the denominator (relative prevalence ranging from 2% to 29%) and when considering only S. aureus as the denominator (relative prevalence ranging from 11% to 65%). Overall, MRSA is among the most frequent causative agents of pulmonary infection in patients with COVID-19. Improving our ability to rapidly reach etiological diagnosis of bacterial lung infection in COVID-19 patients remains fundamental if we are to improve the rates of appropriate antibiotic therapy in patients with COVID-19 and concomitant/superimposed MRSA infection, at the same time avoiding antibiotic overuse in line with antimicrobial stewardship principles.

摘要

目的综述

一些 COVID-19 患者可能会发生肺部细菌合并感染或继发感染,这可能会对其预后产生不利影响。

最新发现

耐甲氧西林金黄色葡萄球菌(MRSA)肺部感染在 COVID-19 等特殊人群中的确切负担仍有些难以捉摸,这可能是因为研究之间的方法和终点存在广泛的异质性。

总结

在检索到的关于 COVID-19 患者中 MRSA 肺部感染的流行病学文献中存在重要的异质性,无论是考虑所有其他细菌作为分母(相对流行率为 2%至 29%)还是仅考虑金黄色葡萄球菌作为分母(相对流行率为 11%至 65%)。总体而言,MRSA 是 COVID-19 患者肺部感染的最常见病原体之一。如果要提高 COVID-19 患者中细菌性肺部感染的病因诊断率,提高 COVID-19 患者合并/继发 MRSA 感染时适当抗生素治疗的比例,同时根据抗菌药物管理原则避免抗生素过度使用,那么提高我们快速做出细菌肺部感染病因诊断的能力仍然是至关重要的。

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