根除社区发病的甲素耐药黄金葡萄球菌携带:一个叙述性审查
Annette C Westgeest1, Jaap L J Hanssen1, Mark G J de Boer2
1Department of Infectious Diseases, Leiden University Medical Center, Leiden, the Netherlands.
概括
甲素耐药黄金葡萄球菌 (MRSA) 脱殖民化策略的有效性各不相同. 建议将局部治疗与口服抗生素结合用于鼻外MRSA殖民,但对于最佳的全身药物需要更多的研究.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 公共卫生 公共卫生
背景情况:
- 耐甲基西林黄金葡萄球菌 (MRSA) 殖民增加了感染风险.
- 脱殖民主义疗法可以减少黄金葡萄球菌感染,但社区发病的MRSA携带数据有限.
- 鼻子脱殖是有效的局部药物,如mupirocin和赫西丁洗.
研究的目的:
- 审查关于消除社区发病MRSA携带者MRSA殖民策略的证据.
- 总结目前对MRSA携带的非殖民化方法.
- 确定有关MRSA脱殖的知识差距.
主要方法:
- 关于MRSA根除研究的叙述性综述.
- 在PubMed数据库上进行文献搜索.
- 从开始收集数据到2023年7月.
主要成果:
- 局部治疗有效地减少了鼻腔MRSA和临时负载.
- 组合疗法 (局部加上口服抗生素) 提高了鼻外殖民的成功率.
- 益生菌提供了一种新的非抗生素策略,但长期成功取决于MRSA的流行率.
- 系统性治疗研究显示出高度的异质性.
结论:
- 针对MRSA根除的治疗决策应该平衡目标 (负载减轻与长期根除) 和成功概率.
- 个人风险因素和重新殖民风险影响了脱殖民主义的成功.
- 系统性抗生素对于鼻外长期脱殖是合理的.
- 需要进一步的研究来确定MRSA脱殖的最佳系统性抗菌剂.
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