在重症监护病房里出现了耐莱涅佐利德耐药黄金葡萄球菌的临床爆发
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
概括
由于广泛使用线索利德,在ICU中发生了耐线索利德黄金葡萄球菌 (LRSA) 疫情. 严格的感染控制和减少linezolid处方成功终止了LRSA爆发.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 医院流行病学 医院流行病学
背景情况:
- 黄金葡萄球菌 (Staphylococcus aureus) 中对线素的耐药性是罕见的.
- 耐线索立德黄金杆菌 (LRSA) 的出现是一个重大的临床挑战.
研究的目的:
- 报告由cfr基因介导的LRSA的第一个临床爆发.
- 描述在疫情爆发期间实施的控制措施.
主要方法:
- 在重症监护病房进行了一项疫情研究.
- 方法包括患者隔离,环境采样和LRSA分离物的分子基因定型.
- 细致地跟踪了linezolid的使用情况和患者的治疗结果.
主要成果:
- 12名患者被确诊患有LRSA,导致呼吸器相关的肺炎和细菌血症.
- 所有的分离物都表现出CFR介导的线化物耐药性.
- 实施感染控制措施和减少使用linezolid导致疫情的结束,随后没有发现新的病例.
结论:
- 这次LRSA爆发与医院内传播和广泛使用linezolid有关.
- 有效的控制包括减少linezolid处方和实施严格的感染控制协议.
- 这凸显了抗微生物药物管理在预防耐药性的重要性.
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