Colonization, fomites, and virulence: Rethinking the pathogenesis of community-associated methicillin-resistant staphylococcus aureus infection
Colonization, fomites, and virulence: Rethinking the pathogenesis of community-associated methicillin-resistant staphylococcus aureus infection
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DOI：
10.1086/526773
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发表时间：
2008-03-01
影响因子：
11.8
通讯作者：
Diep, Binh An
中科院分区：
文献类型：
--
作者：
Miller, Loren G.;Diep, Binh An
社区相关性耐甲氧西林金黄色葡萄球菌(MRSA)感染在全球范围内日益普遍，并导致相当大的发病率和死亡率。令人担忧的是，社区相关的MRSA感染往往是反复发生的，并高度传播给密切接触者。传统的致病原理是MRSA定植先于感染。这促使参与预防社区相关耐甲氧西林金黄色葡萄球菌感染的人将鼻腔局部抗生素的使用纳入鼻腔非殖民化。然而，社区相关耐甲氧西林金黄色葡萄球菌感染暴发的数据表明，皮肤-皮肤和皮肤-真菌接触是感染菌株的重要和常见的替代途径。此外，最成功的社区相关MRSA菌株USA300的菌株特征可能有助于一种不同的发病机制。当我们制定预防社区相关MRSA感染的策略时，我们必须重新考虑金黄色葡萄球菌的发病机制。依赖卫生保健相关的MRSA传播模式来预防社区相关的MRSA感染可能会导致制定有缺陷的战略，削弱我们预防这种严重和潜在致命感染的能力。
Community-associated methicillin-resistant Staphylococcus aureus (MRSA) infection is increasingly common worldwide and causes considerable morbidity and mortality. Of concern, community-associated MRSA infections are often recurrent and are highly transmissible to close contacts. The traditional tenet of pathogenesis is that MRSA colonization precedes infection. This has prompted persons involved in efforts to prevent community-associated MRSA infection to incorporate the use of intranasal topical antibiotics for nasal decolonization. However, data from outbreaks of community-associated MRSA infection suggest that skin-skin and skin-fomite contact represent important and common alternative routes of acquisition of the infecting strain. Furthermore, strain characteristics of the most successful community-associated MRSA strain, USA300, may contribute to a distinct pathogenesis. As we develop strategies to prevent community-associated MRSA infection, we must reconsider the pathogenesis of S. aureus. Reliance on models of health care-associated MRSA transmission for prevention of community-associated MRSA infection may result in the development of flawed strategies that attenuate our ability to prevent this serious and potentially deadly infection.