Harvey K, Pavillard R
Med J Aust. 1982 May 29;1(11):465-7.
There is controversy regarding methods employed for the detection of methicillin resistance in Staphylococcus aureus, and dispute whether infections caused by these organisms can be successfully treated with methicillin or similar antibiotic agents. Cell populations of methicillin-resistant Staph. aureus (MRSA) are heterogeneous with respect to the level of resistance expressed, but always contain a subpopulation of highly resistant cells which can neither be inhibited nor killed by beta-lactam antibiotic agents. Clinical experience confirms that in severe infections, particularly when host defences are imparied, the use of beta-lactam antibiotic agents to treat MRSA is associated with an unacceptably high failure rate. Current Victorian strains of MRSA are multiresistant. Thus vancomycin is the drug of choice for life-threatening infections, while the combination of fusidic acid either with flucloxacillin or with rifampicin is useful for infections of moderate severity.
关于检测金黄色葡萄球菌耐甲氧西林的方法存在争议，对于这些微生物引起的感染能否用甲氧西林或类似抗生素成功治疗也存在争议。耐甲氧西林金黄色葡萄球菌（MRSA）的细胞群体在表达的耐药水平方面是异质的，但总是包含一个高度耐药细胞亚群，该亚群既不能被β-内酰胺类抗生素抑制也不能被杀死。临床经验证实，在严重感染中，特别是当宿主防御功能受损时，使用β-内酰胺类抗生素治疗MRSA的失败率高得令人无法接受。当前维多利亚州的MRSA菌株具有多重耐药性。因此，万古霉素是治疗危及生命感染的首选药物，而夫西地酸与氟氯西林或利福平联合使用对中度严重感染有用。
