Περίληψη:
Methicillin-resistant Staphylococcus aureus (MRSA) should no longer be
regarded as a strictly nosocomial pathogen. During the past decade,
community-acquired MRSA (CA-MRSA) infections among young persons without
healthcare-associated (HCA) risk factors have emerged in several areas
worldwide. These infections are caused by strains that almost
exclusively carry the staphylococcal cassette chromosome mec type IV
element and the Panton-Valentine leukocidin genes and, unlike HCA-MRSA
strains, are not multiresistant. Although the majority of CA-MRSA
infections are mild skin and soft tissue infections, severe
life-threatening cases of necrotizing pneumonia, necrotizing fasciitis,
myonecrosis and sepsis have been reported. Clindamycin is an effective
agent for skin and Soft tissue infections, however attention should be
paid to the possibility of the emergence of resistance during treatment
in strains with the macrolide, lincosamide and group B streptogramin
(MLSB)-inducible resistance phenotype. For patients with invasive
infections that may be caused be CA-MRSA, vancomycin, teicoplanin and
linezolid represent appropriate empirical therapeutic Options. (c) 2005
Elsevier B.V. and the International Society of Chemotherapy. All rights
reserved.
