Methicillin-Resistant Staphylococcus aureus: An Evolving Pathogen
Methicillin-Resistant Staphylococcus aureus: An Evolving Pathogen
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DOI：
10.1093/cid/cit613
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发表时间：
2014-01-01
影响因子：
11.8
通讯作者：
Corey, G. Ralph
中科院分区：
文献类型：
--
作者：
Stryjewski, Martin E.;Corey, G. Ralph
甲氧西林耐药性金黄色葡萄球菌（MRSA）在医院和社区环境中的水平传播，以及这些菌株的日益流行，对全球严重感染的管理提出了重大的临床挑战。虽然感染控制措施阻止了患病率的上升，但MRSA仍然是一种重要的病原体。最近，MRSA对糖肽类药物和新疗法产生耐药性的证据引起了人们对这些疗法在临床实践中的使用的担忧。万古霉素耐药性在选定的临床环境中已变得明显，表现为MIC升高、对异质耐药的认识不断提高以及出现中度耐药和完全耐药菌株。虽然对利奈唑胺和达托霉素的耐药性总体上仍然较低，但已描述了导致利奈唑胺耐药性的点突变，并在临床分离株中报告了cfr介导的利奈唑胺耐药性的水平传播。这些新疗法的耐药性趋势突出了对新的和更有效的抗菌疗法的持续需求。
The horizontal transmission of methicillin resistance to Staphylococcus aureus (MRSA) in hospital and community settings, and growing prevalence of these strains, presents a significant clinical challenge to the management of serious infections worldwide. While infection control initiatives have stemmed the rising prevalence, MRSA remains a significant pathogen. More recently, evidence that MRSA is becoming resistant to glycopeptides and newer therapies raises concern about the use of these therapies in clinical practice. Vancomycin resistance has become evident in select clinical settings through rising MICs, growing awareness of hetero-resistance, and emergence of intermediate-resistant and fully resistant strains. While resistance to linezolid and daptomycin remains low overall, point mutations leading to resistance have been described for linezolid, and horizontal transmission of cfr-mediated resistance to linezolid has been reported in clinical isolates. These resistance trends for newer therapies highlight the ongoing need for new and more potent antimicrobial therapies.