JAC: 耐利奈唑胺葡萄球菌研究进展
本帖最后由 细菌耐药 于 2012-10-14 21:21 编辑8月，我在论文版发了下帖，与大家分享了我的论文被JAC接受的消息：
分享：我在UCLA完成的论文被JAC接受了（附论文修改体会）
http://bbs.sific.com.cn/thread-85084-1-1.html
现在，该论文已正式在JAC在线发表：
The emerging problem of linezolid-resistant Staphylococcus
http://www.ncbi.nlm.nih.gov/pubmed/22949625
下面，我简单地和大家分享一下论文的主要结果。
论文摘要：
J Antimicrob Chemother. 2012 Sep 4.
The emerging problem of linezolid-resistant Staphylococcus.
Gu B, Kelesidis T, Tsiodras S, Hindler J, Humphries RM.
Source
Department of Laboratory Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Abstract
The oxazolidinone antibiotic linezolid has demonstrated potent antimicrobial activity against Gram-positive bacterial pathogens, including methicillin-resistant staphylococci. This article systematically reviews the published literature for reports of linezolid-resistant Staphylococcus (LRS) infections to identify epidemiological, microbiological and clinical features for these infections. Linezolid remains active against >98% of Staphylococcus, with resistance identified in 0.05% of Staphylococcus aureus and 1.4% of coagulase-negative Staphylococcus (CoNS). In all reported cases, patients were treated with linezolid prior to isolation of LRS, with mean times of 20.0 ± 47.0 months for S. aureus and 11.0 ± 8.0 days for CoNS. The most common mechanisms for linezolid resistance were mutation (G2576T) to the 23S rRNA (63.5% of LRSA and 60.2% of LRCoNS) or the presence of a transmissible cfr ribosomal methyltransferase (54.5% of LRSA and 15.9% of LRCoNS). The emergence of linezolid resistance in Staphylococcus poses significant challenges to the clinical treatment of infections caused by these organisms, and in particular CoNS.
PMID: 22949625 文献检索的策略如下，写作之初并没有打算把这篇论文写meta分析，而是作为一般的综述。因此，文献检索的策略并没有写得很详细，也没有绘制文献筛选的流程图。现在回头想想，这方面完全可以做得更好，可以写得更漂亮些。
结果：1. 利奈唑胺耐药的葡萄球菌知多少？Incidence andepidemiology of linezolid resistance
羡慕啊，细菌耐药版主科研能力太牛了！ Congratulations!We're proud of you. 2.利奈唑胺耐药葡萄球菌的克隆传播
Clonal spread of LRS
Three reports of LRSA (13.6% of 22 studies) and 14 reports of
LRCoNS (50% of 28 studies) documented clonal dissemination
of LRS within or across healthcare settings (Table 2). Two LRSA
outbreaks were described in Spain, each involving a single hospital,
and 15 or 12 patients, respectively.13,19 The third LRSA outbreak
was reported from Japan, and involved seven patients in
six different hospitals.20 Both outbreaks in Spain were caused
by LRSA harbouring the mobile cfr resistance gene, whereas
the Japanese study did not test for cfr. Five linezolid-resistant
S. epidermidis with identical PFGE types were recovered from
patients at two geographically disparate institutions in the USA
between 2006 and 2008.7 In Greece, two clones of LRCoNS
were identified among 26 patients in four hospitals.21 Neither
the US nor the Greek isolates harboured cfr. These publications
did not distinguish LRCoNS colonization versus infection. 3. 利奈唑胺耐药葡萄球菌的耐药机制
Mechanisms of linezolid resistance
4. Susceptibility testing and in vitro susceptibility data
看看我入选的文献吧，由于篇幅关系，我在论文中只放了利奈唑胺耐药金黄色葡萄球菌的入选文献。而真正量大的是利奈唑胺耐药的凝固酶阴性的葡萄球菌，那是一张浩大的表格。 在写作和修改过程中，这些文献我前后过了20遍以上。
祝贺！
期待早日看到论文全文，请把论文全文上传论坛。 对了，差点忘了我最喜欢的两张图： 这张显示的是利奈唑胺耐药金黄色葡萄球菌在全球报道的情况
这张显示的是利奈唑胺耐药凝固酶阴性葡萄球菌在全球报道的情况
Conclusions
Linezolid remains highly active against most staphylococci, and
its value in treating serious infections caused by MRSA has
been well documented. Clinicians should remain cognizant that
linezolid resistance may arise following prolonged treatment
with linezolid and of the possibility of LRS in patients that have
not been previously treated with linezolid, given the high incidence
of LRSA carrying cfr. Susceptibility testing for linezolid
resistance should be considered prior to using linezolid for
serious infections. Further, judicious use of linezolid, accurate
identification of resistance and application of strict infection
control measures are essential to the preservation of linezolid
as a therapeutic agent. To date, LRS remain susceptible to vancomycin,
daptomycin and tigecycline. Further studies are needed
to investigate the clinical outcome of LRS infections in order to
optimize treatment of these infections. 鬼才 发表于 2012-10-14 18:14 static/image/common/back.gif
祝贺！
期待早日看到论文全文，请把论文全文上传论坛。
鬼才版主是最喜欢要看全文的{:1_1:}
附上文章的全文，供大家参考~~~~
祝贺！热烈祝贺！敬佩版主的英文水平。 祝贺，羡慕您的英文啊！ 看上去利奈唑胺耐药目前还是以美洲为高发区。
祝贺顾老师的论文发表{:1_17:} 恭喜版主了，真羡慕你的英文水平，不愧在国外待过。 真是羡慕啊！祝贺老师论文发表。
页:
[1]
2