Staphylococcus aureus bacteraemia with known sources
Staphylococcus aureus bacteraemia with known sources
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DOI：
10.1016/j.ijantimicag.2008.06.006
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发表时间：
2008-11-01
影响因子：
10.8
通讯作者：
Rubinstein, Ethan
中科院分区：
文献类型：
--
作者：
Rubinstein, Ethan
耐甲氧西林金黄色葡萄球菌（MRSA），医院获得性和社区获得性MRSA（CA-MRSA）菌株，在过去几年中频率增加，达到流行病的程度。这篇综述讨论了几种临床形式的葡萄球菌感染导致菌血症的病例比例很高。葡萄球菌（MRSA）菌血症性肺炎主要见于医院获得性肺炎和呼吸机相关性肺炎，占所有菌血症的8.4%，占所有院内菌血症的30%，占重症监护室住院患者所有菌血症的68%。在CA-MRSA肺炎患者中，菌血症发生率高达62%。然而，在医院感染的菌血症性肺炎中，血培养在肺炎的第九天变为阳性，而在CA-MRSA菌血症性肺炎中，阳性血培养在感染过程的早期出现。肺炎有一个暴风雨的过程与发展的脓肿，脓胸和广泛的肺损害。脊椎骨髓炎通常发生在静脉内导管使用过程中，引起局部血栓性静脉炎，并可能导致继发性持续菌血症。非脊椎骨髓炎也在增加，近年来发病率翻了一番，主要是由于耐甲氧西林金黄色葡萄球菌（MRSA）。血液系统恶性肿瘤患者特别容易发生这种并发症，通常发生在管路感染之后。硬膜外脓肿是葡萄球菌菌血症最严重的后果，如果诊断不及时，会导致永久性神经损伤。(c)2008年爱思唯尔B。和国际化疗学会。All rights reserved.
Meticillin-resistant Staphylococcus aureus (MRSA), both hospital-acquired and community-acquired MRSA (CA-MRSA) strains, have increased in frequency in the last few years, reaching epidemic dimensions. This review discusses several clinical forms of staphylococcal infection leading to bacteraemia in a high proportion of cases. Staphylococcal (MRSA) bacteraemic pneumonia is predominantly seen in hospital-acquired pneumonia and ventilator-associated pneumonia, reaching a frequency of 8.4% of all bacteraemias, 30% of all nosocomial bacteraemias and 68% of all bacteraemias of patients hospitalised in Intensive Care Units. In patients with CA-MRSA pneumonia, the rate of bacteraemia is as high as 62%. Whereas in nosocomial bacteraemic pneumonia blood cultures become positive on the ninth day of pneumonia, in CA-MRSA bacteraemic pneumonia positive blood cultures appear early in the course of the infection. The pneumonia has a stormy course with the development of abscesses, empyema and extensive pulmonary damage. Vertebral osteomyelitis commonly occurs during intravenous catheter use, causing local thrombophlebitis that will seed to vertebral bodies and disks and may cause secondary sustained bacteraemia. Non-vertebral osteomyelitis is also on the increase, with a frequency that has doubled in recent years, mainly due to MRSA. Patients with haematological malignancies are particularly prone to this complication, usually following line infections. Epidural abscess is the most serious consequence of staphylococcal bacteraemia, leading to permanent neurological damage if not diagnosed early enough. (c) 2008 Elsevier B. V. and the International Society of Chemotherapy. All rights reserved.