斯塔菲洛科克黄金菌血病的临床管理:一篇综述
Thomas L Holland1, Christopher Arnold2, Vance G Fowler1
1Division of Infectious Diseases and International Health, Department of Medicine, Duke University School of Medicine, Durham, North Carolina2Duke Clinical Research Institute, Duke University, Durham, North Carolina.
JAMA
|October 1, 2014
概括
对于所有患有黄金菌杆菌菌病的患者,建议通过食道进行心声回声扫描. 某些低风险因素可能允许避免,而万科米辛或托米辛是MRSA细菌病的首选药物.
科学领域:
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 黄金葡萄球菌菌病 (SAB) 管理需要有效的策略.
- 确定转食道心声学 (TEE) 和最佳抗生素治疗对抗甲素耐药S. aureus (MRSA) 细菌的必要性至关重要.
研究的目的:
- 审查SAB管理策略的证据.
- 评估TEE在成人SAB病例中的作用.
- 为了确定MRSA细菌病的最佳抗生素治疗.
主要方法:
- 在PubMed,EMBASE和Cochrane图书馆 (成立于2014年5月) 的系统文献搜索.
- 在SAB中包括TEE的研究和MRSA细菌病的抗生素治疗.
- 使用推,评估,发展和评估等级 (GRADE) 评估证据质量.
主要成果:
- 在SAB中使用TEE与更高的内心炎诊断率 (14%-28%) 与横心回声 (2%-15%) 相比有关.
- 确定了在SAB患者中潜在避免TEE的特定低风险因素.
- 范科米辛和达普托米辛在治疗MRSA细菌病的疗效相似.
结论:
- 推对所有患有S. aureus bacteremia的成年患者进行心声扫描.
- 已经确定了在SAB中避免TEE的低风险患者特征.
- 建议使用万科米辛和达普托米辛作为MRSA细菌血症的第一线药物.
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