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MRSA : Most frequently isolated multidrug resistant pathogen Shin Nihonyanagi 1 , Hideaki Hanaki 2 1Department of Medical Laboratory, Kitasato University Hospital 2Kitasato Institute for Life Science & Laboratory for Antimicrobial Agents, Kitasato University Keyword: HA-MRSA , CA-MRSA , PK/PD , MIC pp.375-380
Published Date 2012/4/15
DOI https://doi.org/10.11477/mf.1542102978
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Methicillin-resistant Staphylococcus aureus (MRSA) may be defined as the S. aureus strains, which are (i) resistant to oxacillin and cefoxitin, and which show (ii) the occurrence of penicillin binding protein (PBP2′) and mecA gene. Though the original designation of MRSA implied methicillin-resistant, the bacterium is virtually multidrug resistant to structurally and functionally dissimilar chemotherapeutic agents. The first choice antibiotics for the treatment of MRSA infections may be to use glycopeptide antibiotics such as vancomycin. MRSA strains which show the minimum growth inhibitory concentration (MIC) of vancomycin 4-8 μg/ml were defined as intermediately vancomycin susceptible. However, the vancomycin therapy for such MRSA infection often results in failure. It is said that vancomycin treatment may be ineffective even in infection of MRSA with MIC of vancomycin 2 μg/ml. Therefore, vancomycin therapy based on the conventional in vitro MIC determination should be reconsidered. One of the solutions could be to determine MIC of vancomycin based on pharmacokinetics/pharmacodynamics (PK/PD) analyses and to design a suitable vancomycin dosage. Another concern on MRSA infection would be the markedly increasing trend of community-acquired MRSA, which produces the life-threatening toxin, Panton-Valentine leukocidin.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1367 印刷版ISSN 0485-1420 医学書院

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