集中治療室でラインゾリド耐性黄金球菌の臨床発症
Miguel Sánchez García1, María Angeles De la Torre, Gracia Morales
1Intensive Care Department, Hospital Clínico San Carlos and Universidad Complutense, 28040 Madrid, Spain. msanchezga.hcsc@salud.madrid.org
JAMA
|June 10, 2010
まとめ
ラインゾリド耐性黄金球菌 (LRSA) の発生がICUで発生し,その原因はラインゾリドの広範な使用であった. 厳格な感染制御とラインゾリドの処方箋の削減により,LRSAの発生が成功しました.
科学分野:
- 感染症 感染症は感染症です.
- クリニカル・マイクロバイオロジー
- 病院疫学 病院疫学について
背景:
- Staphylococcus aureusにおけるラインゾリド耐性は稀である.
- ラインゾリド耐性S. aureus (LRSA) の出現は,重要な臨床的課題となっている.
研究 の 目的:
- cfr遺伝子によって媒介されるLRSAの最初の臨床アウトブレイクを報告する.
- 疫病発生時に実施された対策について説明します.
主な方法:
- 集中治療室でアウトブレイクに関する研究が行われました.
- 方法には,患者の隔離,環境サンプル採取,LRSA単離物の分子ゲノタイプ化が含まれていました.
- ラインゾリドの使用と患者のアウトカムが注意深く追跡されました.
主要な成果:
- 12人の患者は,呼吸器関連肺炎と細菌血症を引き起こすLRSAと診断されました.
- すべての単離体は,cfr媒介のラインゾリド耐性を示した.
- 感染制御対策の実施とラインゾリドの使用の削減により,アウトブレイクが終了し,その後新たな症例は確認されなかった.
結論:
- LRSAの発生は,病院内感染と,ラインゾリドの広範な使用に関連していた.
- 効果的な予防には,ラインゾリドの処方量を減らし,厳格な感染制御プロトコルを実施することが必要でした.
- これは,抗菌剤の管理が耐性を予防する上で重要であることを強調しています.
関連する概念動画
Clinical Significance of Antibiotic Resistance
Methicillin-resistant Staphylococcus aureus (MRSA) presents a critical public health threat, arising from its capacity to resist β-lactam antibiotics due to acquisition of the mecA gene within the staphylococcal cassette chromosome mec (SCCmec). This gene encodes penicillin-binding protein 2a (PBP2a), which impairs binding efficacy of methicillin and other β-lactams. MRSA has evolved into distinct clonal lineages impacting humans and animals alike, reinforcing its significance within the One...
Mechanism of Antibiotic Resistance in MRSA
Antibiotic resistance in bacteria arises when microorganisms evolve the ability to withstand drugs designed to kill them or inhibit their growth, rendering once-effective treatments useless. This phenomenon, driven by genetic change and selection under antibiotic exposure, poses a profound threat to modern medicine. Mechanisms include drug-inactivating enzymes (e.g., β-lactamases), efflux pumps that eject antibiotics, mutations altering antibiotic targets, decreased drug uptake, and acquisition...
Staphylococcal Skin Infections
Staphylococcus aureus is a Gram-positive coccus that resides harmlessly on the skin and mucous membranes of healthy individuals. When the skin barrier is breached, it can shift from a commensal to an opportunistic pathogen. This transition is facilitated by surface adhesins, such as clumping factor B and S. aureus surface protein G (SasG), which bind to structural proteins, including loricrin and cytokeratin, in the damaged epidermis. Protein A, another key factor, binds the Fc region of...
Healthcare Associated Infections II: Preventive Measures
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
Healthcare-associated infections (HAIs) occur in a healthcare facility while a person receives care for another ailment. This category also includes work-related infections among healthcare staff.
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies. Common...
Acute Pyelonephritis II: Diagnostic Studies and Management
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
