关键词: Bacteremia Bacteriemia Clinical guidelines Documento de consenso Endocarditis infecciosa Infective endocarditis Methicillin-resistant Methicillin-susceptible Resistente a meticilina Sensible a meticilina Staphylococcus aureus

Mesh : Anti-Bacterial Agents / pharmacology therapeutic use Bacteremia / diagnosis drug therapy microbiology Cross Infection / diagnosis drug therapy microbiology Disease Management Endocarditis, Bacterial / diagnosis drug therapy microbiology surgery Humans Methicillin-Resistant Staphylococcus aureus / drug effects isolation & purification Microbial Sensitivity Tests Polymerase Chain Reaction Population Surveillance Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization Standard of Care Staphylococcal Infections / diagnosis diagnostic imaging drug therapy

来  源:   DOI:10.1016/j.eimc.2015.03.015   PDF(Sci-hub)

Abstract:
Both bacteremia and infective endocarditis caused by Staphylococcus aureus are common and severe diseases. The prognosis may darken not infrequently, especially in the presence of intracardiac devices or methicillin-resistance. Indeed, the optimization of the antimicrobial therapy is a key step in the outcome of these infections. The high rates of treatment failure and the increasing interest in the influence of vancomycin susceptibility in the outcome of infections caused by both methicillin-susceptible and -resistant isolates has led to the research of novel therapeutic schemes. Specifically, the interest raised in recent years on the new antimicrobials with activity against methicillin-resistant staphylococci has been also extended to infections caused by susceptible strains, which still carry the most important burden of infection. Recent clinical and experimental research has focused in the activity of new combinations of antimicrobials, their indication and role still being debatable. Also, the impact of an appropriate empirical antimicrobial treatment has acquired relevance in recent years. Finally, it is noteworthy the impact of the implementation of a systematic bundle of measures for improving the outcome. The aim of this clinical guideline is to provide an ensemble of recommendations in order to improve the treatment and prognosis of bacteremia and infective endocarditis caused by S. aureus, in accordance to the latest evidence published.
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