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DOI: 10.1055/s-0038-1628955
Rezidivierende Staphylococcus aureus- Infektionen
Recurrent Staphylococcus aureus infectionsPublication History
Eingegangen:
01 October 2007
angenommen:
19 October 2007
Publication Date:
25 January 2018 (online)
Zusammenfassung
Rezidive bei S. aureus-Infektionen sind häufig. Wirtsfaktoren, erregerspezifische Pathogenitätsfaktoren, aber auch eine inadäquate Therapie sind hierfür verantwortlich. Sie betreffen Haut- und Weichteilinfektionen ebenso wie Bakteriämien und sind von besonderer Bedeutung bei nichtentfernten oder -entfernbaren Fremdkörpern. Biofilmbildung und sogenannte Small Colony Variants spielen eine wichtige pathogenetische Rolle durch die Induktion von Resistenz gegenüber Antibiotika und körpereigenen antimikrobiellen Substanzen. Eine hoch dosierte Betalaktam- Therapie und ausreichende Therapiedauer sind für gute Behandlungsergebnisse wichtige Faktoren. Eine sorgfältige diagnostische Abklärung von Organabsiedelungen senkt die Rezidivrate der S. aureus-Bakteriämie.
Summary
Recurrent S. aureus infections are a frequent clinical problem. Host factors, virulence factors and inadequate medical therapy may be involved in recurrence of the infection. Skin and soft tissue, bloodstream and foreign body infections account most frequently for recurrent staphylococcal disease. In the setting of biofilm and small colony variants increased resistance against antibiotics as well as endogenous antimicrobial peptides is encountered. Adequate dosage and duration of the antimicrobial and preferred usage of beta lactams improves patient outcome. A thorough diagnostic workup to detect deep seated infection reduces the rate of recurrence in S. aureus bacteremia.
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