本帖最后由 鬼才 于 2015-1-19 00:15 编辑
INTRODUCTION 引言 It was 20 years ago that Kloos and Bannerman (1) updated our knowledge on the clinical significance of coagulase-negative staphylococci (CoNS), following a review, 6 years previously, of their laboratory, clinical, and epidemiological aspects by Pfaller and Herwaldt (2), both in this journal. Although the pathogenic potential of CoNS had become accepted by the end of the 1980s, most of the underlying molecular mechanisms still awaited discovery. Presently, a PubMed search on CoNS results in more than 15,000 references, reflecting the increasing medical impact of these bacteria. 在这本杂志中，20年前，Kloos和Bannerman (1)更新了凝固酶阴性葡萄球菌在临床意义上的知识，随后，六年前Pfaller 和Herwaldt（2）的一篇综述，在实验室、临床和流行病学方面对凝固酶阴性葡萄球菌的知识进行了更新。尽管凝固酶阴性葡萄球菌的潜在致病性已在80年代得到认可，然而其大多数相关的分子机理仍然等待发现。目前，在PubMed中搜索“CoNS”，超过15000篇文献，这反映了这些细菌在医学上重要性与日俱争。 Over the past 2 decades, the research toolbox has greatly expanded, providing a large array of modern molecular and phenotypic methods, including the routine use of whole-genome sequencing and mass spectrometric approaches. Nevertheless, the problem of an increasing health burden due to CoNS infections is far from resolved. Demographic and medical developments creating more elderly, multimorbid, and immunocompromised patients and the increasing use of inserted or implanted foreign bodies have contributed to the progressively increasing importance of CoNS in health care. Furthermore, as for other nosocomial pathogens, increasing rates of antibiotic resistance are an even greater problem for CoNS than for Staphylococcus aureus, limiting our therapeutic options. 在过去20年中，研究工具有了大的扩充，一大批现代基因和表型方式可供使用，包括全基因测试组和质谱分析方法的日常使用。然而，由凝固酶阴性葡萄球菌感染引起的医疗负担增加远远没有得到解决。随着人口和医学的发展，使得有更多的年老人、身患多种疾病的人和免疫功能不全的病人，外来物插入和植入的使用也增多，使得在医疗过程中越来越重视凝固酶阴性葡萄球菌。此外，限于我们的治疗方式，同其他的医院病原体一样，凝固酶阴性葡萄球菌与金黄色葡萄球菌相比，抗生素耐药比率的增高是一个很大的问题。 Describing CoNS is challenging because they represent a heterogeneous group within the genus Staphylococcus that is not based on phylogenetic relationships. They were defined by delimitation from coagulase-positive staphylococci (CoPS), i.e., Staphylococcus aureus, the only known coagulase-positive species at the time of the introduction of this concept. Superficially, this concept seemed to be solely a diagnostic procedure-based classification, but it became a clinical approach to differentiate between the pathogenic species S. aureus and a group of staphylococci initially classified as nonpathogenic. A deeper understanding of the nature of CoNS has now fundamentally changed our views. 由于凝固酶阴性葡萄球菌是葡萄球菌属中的一个异质组，描述凝固酶阴性葡萄球菌具有挑战性，不能基于系统发育关系。他们的定义受凝固酶阳性葡萄球菌的界定，即金黄色葡萄球菌，引进这一概念时，唯一已知的凝固酶阳性菌属。表面上看，这概念好象是仅基于诊断规程的分类，但它已成为区分致病的种属金黄色葡萄球菌与最初分类中无致病性的一组葡萄球菌的临床方法。对凝固酶阴性葡萄球菌所具特性的更深了解，现在已从根本上改变了我们的观点。 In this review, human medical issues and the epidemiological, pathogenetic, clinical, diagnostic, and therapeutic aspects of CoNS and their infections in relation to the pathogens’ biology are reviewed. For aspects of CoNS related to veterinary medicine and food production, please refer to specialized reviews (3, 4). 在这篇综述中，将对人类健康问题与凝固酶阴性葡萄球菌的流行病学、致病性、临床、诊断、治疗方面及与凝固酶阴性葡萄球菌相关联的病原体生态学等方面的问题进行综述。凝固酶阴性葡萄球菌与兽医学、食品生产方面的问题，请参阅专门的综述(3, 4)。 (未完待续) | 
发表于 2015-1-19 00:11
