Hashisaki P A, Jacobson J A
Clin Pharm. 1982 Jul-Aug;1(4):343-8.
The history, in vitro characteristics, epidemiology, clinical observations, control measures, and therapy of methicillin-resistant Staphylococcus aureus (MRSA) infections are reviewed. Strains of MRSA have been implicated in nosocomial infections, particularly in hospitals associated with medical schools. In vitro, MRSA cultures usually have only a small percentage of organisms that are resistant to methicillin. Patient-specific risk factors for acquiring MRSA infections have been identified in uncontrolled and controlled studies. Environmental culturing to identify sources of contamination has been nonproductive. Physical control measures such as good handwashing and proper isolation have produced variable results in dealing with MRSA. Other suggested measures for reducing the incidence of MRSA colonization include: increasing the nurse-to-patient ratio in intensive-care units; treatment of patients and hospital employees who are colonized with MRSA; and restriction of antibiotics. The drug of choice for treating MRSA infections is vancomycin given intravenously (peripherally or centrally) or by Ommaya reservoir (for CNS infections if bactericidical concentrations are not reached with i.v. doses). Vancomycin may be used empirically for patients at high risk for developing MRSA infections before culture-and-sensitivity reports are available.
本文综述了耐甲氧西林金黄色葡萄球菌（MRSA）感染的历史、体外特性、流行病学、临床观察、控制措施及治疗方法。MRSA菌株与医院感染有关，尤其是在与医学院相关的医院中。在体外，MRSA培养物中通常只有一小部分生物体对甲氧西林耐药。在非对照和对照研究中已确定了获得MRSA感染的患者特异性危险因素。通过环境培养来确定污染源的方法并未取得成效。诸如良好的洗手和适当的隔离等物理控制措施在应对MRSA方面产生了不同的结果。其他建议的降低MRSA定植发生率的措施包括：增加重症监护病房的护士与患者比例；治疗MRSA定植的患者和医院员工；以及限制使用抗生素。治疗MRSA感染的首选药物是静脉注射（外周或中心）万古霉素，或通过奥马亚贮器给药（如果静脉注射剂量未达到杀菌浓度，则用于中枢神经系统感染）。在获得培养和药敏报告之前，万古霉素可经验性地用于有发生MRSA感染高风险的患者。
