Methicillin and Vancomycin Resistant S. aureus in Hospitalized Patients
Methicillin and Vancomycin Resistant S. aureus in Hospitalized Patients
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DOI：
10.4103/0974-777x.68535
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发表时间：
2010-09-01
影响因子：
1.6
通讯作者：
Mishra, Bibhabati
中科院分区：
文献类型：
--
作者：
Loomba, Poonam Sood;Taneja, Juhi;Mishra, Bibhabati
S.金黄色葡萄球菌是皮肤、软组织和骨感染的主要细菌原因，也是卫生保健相关菌血症的最常见原因之一。医院相关耐甲氧西林链球菌金黄色葡萄球菌（MRSA）携带与感染、发病率和死亡率的风险增加相关。事实证明，在入院和非殖民化时对高危患者进行筛查是减少医院内传播的一个重要因素。在PubMed电子数据库中检索所有关于“MRSA的建立和万古霉素耐药S.金黄色葡萄球菌（VRSA）。“搜索包括病例报告，病例系列和评论。对所有文献进行交叉引用，以检索更多可用文献。共获得88篇参考文献。研究表明，万古霉素中间型和万古霉素耐药S。金黄色。万古霉素的广泛使用会产生选择压力，有利于罕见的万古霉素耐药克隆的生长，从而产生异质性万古霉素中间体S。金黄色葡萄球菌hVISA克隆，并最终持续暴露于万古霉素中间体S.金黄色葡萄球菌（VISA）克隆。然而，鉴定hVISA菌株的标准尚未标准化，使其临床意义和在治疗失败中的作用的任何确定变得复杂。MRSA从医院传播到社区，再加上VISA和VRSA的出现，已经成为医疗保健提供者的主要关注点。预防控制措施、可靠的耐药性实验室筛查、适当的抗生素处方做法和避免全面治疗可以防止长期出现耐药性。
S. aureus is the major bacterial cause of skin, soft tissue and bone infections, and one of the commonest causes of healthcare-associated bacteremia. Hospital-associated methicillin-resistant S. aureus (MRSA) carriage is associated with an increased risk of infection, morbidity and mortality. Screening of high-risk patients at the time of hospital admission and decolonization has proved to be an important factor in an effort to reduce nosocomial transmission. The electronic database Pub Med was searched for all the articles on "Establishment of MRSA and the emergence of vancomycin-resistant S. aureus (VRSA)." The search included case reports, case series and reviews. All the articles were cross-referenced to search for any more available articles. A total of 88 references were obtained. The studies showed a steady increase in the number of vancomycin-intermediate and vancomycin-resistant S. aureus. Extensive use of vancomycin creates a selective pressure that favors the outgrowth of rare, vancomycin-resistant clones leading to heterogenous vancomycin intermediate S. aureus hVISA clones, and eventually, with continued exposure, to a uniform population of vancomycin-intermediate S. aureus (VISA) clones. However, the criteria for identifying hVISA strains have not been standardized, complicating any determination of their clinical significance and role in treatment failures. The spread of MRSA from the hospital to the community, coupled with the emergence of VISA and VRSA, has become major concern among healthcare providers. Infection-control measures, reliable laboratory screening for resistance, appropriate antibiotic prescribing practices and avoidance of blanket treatment can prevent long-term emergence of resistance.