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革兰阳性菌是一类最常见的致病菌。随着抗生素的广泛使用以及不合理用药,某些革兰阳性菌(尤其是葡萄球菌、肺炎球菌和肠球菌)的耐药性逐年增加,已成为近年临床医师必需面对的最大挑战。免疫法在预防某些革兰阳性菌感染(如白喉和破伤风)方面非常成功,目前肺炎球菌疫苗和金葡菌疫苗分别处于改进和研发中。本文比较系统地综述了革兰阳性菌重度感染的治疗趋势,包括老药新用以及近年上市的和待审批的新抗生素(奎奴普丁/达福普汀、替加环素、利奈唑胺、达托霉素和达巴万星等)在治疗这类感染的应用。简单介绍了处于研发阶段的具有抗MRSA、耐青霉素链球菌和VRE活性的β-内酰胺类、链阳性菌素类和喹诺酮类药物等。同时强调耐多药致病菌患者的及时确诊以及适当隔离等感染控制措施的重要性。
Gram-positive bacteria are a group of the most common pathogenic bacteria. With the widespread use of antibiotics and irrational drug use, the increasing resistance of some Gram-positive bacteria, especially staphylococci, pneumococci and enterococci, has become the biggest challenge that clinicians must face in recent years. Immunization is very successful in preventing certain Gram-positive infections, such as diphtheria and tetanus, and pneumococcal vaccines and S. aureus vaccines are currently being improved and developed respectively. This article systematically reviewed the trend of the treatment of Gram-positive bacteria severe infections, including the new drugs used old and listed in recent years and pending approval of new antibiotics (quinupristin / dalfopristin, tigecycline, linezolid , Daptomycin and dalbavancin, etc.) in the treatment of such infections. Briefly introduced in the research and development phase with anti-MRSA, penicillin-resistant Streptococcus and VRE activity of β-lactam, streptotactic and quinolone drugs. At the same time, it emphasizes the importance of promptly diagnosing patients with multidrug-resistant pathogens and appropriate infection control measures such as isolation.