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中华重症医学电子杂志 ›› 2019, Vol. 05 ›› Issue (02) : 109 -114. doi: 10.3877/cma.j.issn.2096-1537.2019.02.006

所属专题: 重症医学 文献

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耐甲氧西林金黄色葡萄球菌血流感染:关注感染来源和去路
刘军1,()   
  1. 1. 215001 南京医科大学附属苏州医院ICU
  • 收稿日期:2019-02-11 出版日期:2019-05-28
  • 通信作者: 刘军
  • 基金资助:
    江苏省第五期"333工程"科研项目(BRA2016070); 江苏省苏州市临床重点病种诊疗技术专项(LCZX201607); 江苏省苏州市科技发展计划项目(SS201874)

Methicillin-resistant Staphylococcus aureus bloodstream infection: primary sources and dissemination sites

Jun Liu1,()   

  1. 1. Department of Critical Care Medicine, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou 215001, China
  • Received:2019-02-11 Published:2019-05-28
  • Corresponding author: Jun Liu
  • About author:
    Corresponding author: Liu Jun, Email:
引用本文:

刘军. 耐甲氧西林金黄色葡萄球菌血流感染:关注感染来源和去路[J]. 中华重症医学电子杂志, 2019, 05(02): 109-114.

Jun Liu. Methicillin-resistant Staphylococcus aureus bloodstream infection: primary sources and dissemination sites[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2019, 05(02): 109-114.

耐甲氧西林金黄色葡萄球菌(MRSA)血流感染发病率和病死率居高不下。规范留取血标本后血培养阳性是诊断菌血症的金标准。临床诊断MRSA血流感染后应注意寻找可能的原发感染源和迁徙感染灶,及时处理原发感染灶和转移性感染灶是MRSA血流感染治疗成功的前提与基础。指南推荐万古霉素和达托霉素是治疗MRSA血流感染的一线抗生素,而利奈唑胺可作为万古霉素耐药或合并肾功能不全MRSA血流感染患者补救性治疗。系统回顾MRSA血流感染若干热点问题,关注感染来源和去路,具有重要临床意义。

The morbidity and mortality of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infection remain high. The positive blood culture of MRSA is the gold standard for diagnosis of bacteremia. After clinical diagnosis of MRSA bloodstream infection, clinicians should identify the possible primary infection sources and dissemination sites. This is the premise and foundation of successful and timely treatment of MRSA bloodstream infection. The guidelines have recommended Vancomycin and Daptomycin as first-line antibiotics in the treatment of MRSA bloodstream infections, while Linazolamide can be used as a salvage therapy for patients with vancomycin resistance or renal dysfunction. Remarkably, it is of great significance to systematically review some hot issues of MRSA bloodstream infection, with an emphasis on the sources of infection and dissemination sites.

1
Aliberti S, Reyes LF, Faverio P, et al. Global initiative for meticillin-resistant Staphylococcus aureus pneumonia (GLIMP): An international, observational cohort study [J]. Lancet Infect Dis, 2016, 16(12):1364-1376.
2
Cassini A, Högberg LD, Plachouras D, et al. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: a population-level modelling analysis [J]. Lancet Infect Dis, 2019, 19(1):56-66.
3
Thwaites GE, Edgeworth JD, Gkrania-Klotsas E, et al. Clinical management of Staphylococcus aureus bacteraemia [J]. Lancet Infect Dis, 2011, 11(3):208-222.
4
Holland TL, Arnold C, Fowler VG. Clinical management of Staphylococcus aureus bacteremia: a review [J]. JAMA, 2014, 312(13):1330-1341.
5
Holland TL, Raad I, Boucher HW, et al. Effect of algorithm-based therapy vs usual care on clinical success and serious adverse events in patients with Staphylococcal bacteremia: A randomized clinical trial [J]. JAMA, 2018, 320(12):1249-1258.
6
Tong SY, Davis JS, Eichenberger E, et al. Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management [J]. Clin Microbiol Rev, 2015, 28(3):603-661.
7
Thomer L, Schneewind O, Missiakas D. Pathogenesis of Staphylococcus aureus bloodstream infections [J]. Annu Rev Pathol, 2016, 11:343-364.
8
Rupp ME, Karnatak R. Intravascular catheter-related bloodstream infections [J]. Infect Dis Clin North Am, 2018, 32(4):765-787.
9
Surewaard BG, Deniset JF, Zemp FJ, et al. Identification and treatment of the Staphylococcus aureus reservoir in vivo [J]. J Exp Med, 2016, 213(7):1141-1151.
10
Minasyan H. Sepsis and septic shock: pathogenesis and treatment perspectives [J]. J Crit Care, 2017, 40:229-242.
11
Kim KS. Mechanisms of microbial traversal of the blood-brain barrier [J]. Nat Rev Microbiol, 2008, 6(8):625-634.
12
Minejima E, Bensman J, She RC, et al. A dysregulated balance of proinflammatory and anti-inflammatory host cytokine response early during therapy predicts persistence and mortality in Staphylococcus aureus bacteremia [J]. Crit Care Med, 2016, 44(4):671-679.
13
Martínez ML, Ferrer R, Torrents E, et al. Impact of source control in patients with severe sepsis and septic shock [J]. Crit Care Med, 2017, 45(1):11-19.
14
Soriano A, Marco F, Martínez JA, et al. Influence of vancomycin minimum inhibitory concentration on the treatment of methicillin-resistant Staphylococcus aureus bacteremia [J]. Clin Infect Dis, 2008, 46(2):193-200.
15
Liao CH, Chen SY, Huang YT, et al. Outcome of patients with meticillin-resistant Staphylococcus aureus bacteraemia at an Emergency Department of a medical centre in Taiwan [J]. Int J Antimicrob Agents, 2008, 32(4):326-332.
16
Chastre J, Blasi F, Masterton RG, et al. European perspective and update on the management of nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus after more than 10 years of experience with linezolid [J]. Clin Microbiol Infect, 2014, 20(S4):19-36.
17
Cahill TJ, Baddour LM, Habib G, et al. Challenges in infective endocarditis [J]. J Am Coll Cardiol, 2017, 69(3):325-344.
18
Seah J, Lye DC, Ng TM, et al. Vancomycin monotherapy vs. combination therapy for the treatment of persistent methicillin-resistant Staphylococcus aureus bacteremia [J]. Virulence, 2013, 15, 4(8):734-739.
19
Holland TL, Baddour LM, Bayer AS, et al. Infective endocarditis [J]. Nat Rev Dis Primers, 2016, 2:16059.
20
Coburn B, Morris AM, Tomlinson G, et al. Does this adult patient with suspected bacteremia require blood cultures? [J]. JAMA, 2012, 308(5):502-511.
21
Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock [J]. Crit Care Med, 2006, 34(6):1589-1596.
22
Hamdy RF, Hsu AJ, Stockmann C, et al. Epidemiology of methicillin-resistant Staphylococcus aureus bacteremia in children [J]. Pediatrics, 2017, 139(6):e20170183.
23
Mahajan SN, Shah JN, Hachem R, et al. Characteristics and outcomes of methicillin-resistant Staphylococcus aureus bloodstream infections in patients with cancer treated with vancomycin: 9-year experience at a comprehensive cancer center [J]. Oncologist, 2012, 17(10):1329-1336.
24
Gudiol C, Cuervo G, Shaw E, et al. Pharmacotherapeutic options for treating Staphylococcus aureus bacteremia [J]. Expert Opin Pharmacother, 2017, 18(18):1947-1963.
25
Chen SL, Zhu CY, Zhou H, et al. Efficacy and safety of linezolid among patients with methicillin-resistant Staphylococcus aureus bacteremia [J]. Natl Med J China, 2017, 97(14):1084-1088.
26
Jang HC, Kim SH, Kim KH, et al. Salvage treatment for persistent methicillin-resistant Staphylococcus aureus bacteremia: efficacy of linezolid with or without carbapenem [J]. Clin Infect Dis, 2009, 49(3):395-401.
27
Perencevich EN, Malani PN. Treatment algorithms for staphylococcal bacteremia: Improving clinical care and enhancing antimicrobial stewardship [J]. JAMA, 2018, 320(12):1243-1244.
28
Baddour LM, Wilson WR, Bayer AS, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: A scientific statement for healthcare professionals from the American Heart Association [J]. Circulation, 2015, 132(15):1435-1486.
29
Tängdén T, Ramos MV, Felton TW, et al. The role of infection models and PK/PD modelling for optimising care of critically ill patients with severe infections [J]. Intensive Care Med, 2017, 43(7):1021-1032.
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