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首页> 外文期刊>Chest Disease Reports >Clinical and microbiological characteristics of communityacquired methicillin-resistant Staphylococcus aureus pneumonia
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Clinical and microbiological characteristics of communityacquired methicillin-resistant Staphylococcus aureus pneumonia

机译：社区获得性耐甲氧西林金黄色葡萄球菌肺炎的临床和微生物学特征

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Methicillin-resistant Staphylococcus aureus (MRSA) infections now occur in healthy adults in community settings. We searched the PubMed database to identify relevant articles on the clinical presentation, epidemiology, virulence, and treatment of community-acquired MRSA (CA-MRSA) infections, including pneumonia. This information was summarized in a narrative review.MRSA infections cause approximately 30 infections per 100,000 people per year in the USA, and twenty percent of these infections are secondary to CA-MRSA. These community-acquired infections often involve the skin and subcutaneous tissue but can also involve visceral tissues such as the lung and bone. The overall mortality in patients with invasive disease is approximately 10%; it approaches 50% in patients with pneumonia. The bacterial isolates from these infections have the staphylococcal chromosome cassette mec types 4 and 5. This genetic characteristic produces beta-lactam resistance and helps distinguish these isolates from hospital- acquired MRSA, which usually have mec types 1-3. Some CA-MRSA isolates release the Panton-Valentine leukocidin (PVL), which causes neutropenia and tissue necrosis; other toxins also contribute to the virulence of these infections. Empiric therapy should include vancomycin or linezolid. CA-MRSA infections can have fulminant courses and high mortality rates. Physicians should consider these infections as possible emergencies with a high risk for organ system failure and shock.
机译：耐甲氧西林金黄色葡萄球菌（MRSA）感染现在发生在社区环境中的健康成年人中。我们搜索了PubMed数据库，以识别有关社区获得性MRSA（CA-MRSA）感染（包括肺炎）的临床表现，流行病学，毒力和治疗的相关文章。叙事性评论总结了这些信息。在美国，MRSA感染每年每100,000人中大约引起30例感染，其中20％的感染是CA-MRSA继发的。这些社区获得性感染通常涉及皮肤和皮下组织，但也可能涉及内脏组织，例如肺和骨骼。浸润性疾病患者的总死亡率约为10％;在肺炎患者中，这一比例接近50％。来自这些感染的细菌分离株具有4和5型葡萄球菌染色体盒。这种遗传特征产生β-内酰胺抗性，有助于将这些分离株与通常为1-3型的医院获得的MRSA区别开来。一些CA-MRSA分离物释放出Panton-Valentine白细胞抑制素（PVL），从而引起中性粒细胞减少和组织坏死。其他毒素也有助于这些感染的毒性。经验疗法应包括万古霉素或利奈唑胺。 CA-MRSA感染的病程很长，死亡率很高。医师应将这些感染视为可能的紧急情况，对器官系统衰竭和休克的风险很高。

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