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Multiresistente grampositive Erreger (MRSA, VRE)

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SpringerReference Innere Medizin

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Zusammenfassung

Die bedeutendsten grampositiven Erreger mit Mehrfachresistenz gegen Antibiotika stellen Methicillin-resistente Staphylococcus aureus (MRSA) und Vancomycin-resistente Enterokokken (VRE) dar. Ein umfassendes Verständnis des Klinikers für die Invasivität von MRSA sowie das kolonisierende Verhalten von VRE sind essentiell für eine adäquate Diagnostik und Therapie der durch diese Erreger verursachten Infektionen. Die Kenntnis von Resistenzmustern ist einerseits wegweisend für einen angemessenen Einsatz derzeit verfügbarer Antibiotika und andererseits maßgeblich für ein adäquates krankenhaushygienisches Management. Aufgrund des Resistenzmechanismus, der MRSA zugrunde liegt, können Betalactamantibiotika mit Ausnahme von Ceftarolin nicht für die Therapie verwendet werden. Antibiotika der Wahl bei MRSA sind Vancomycin und Teicoplanin sowie Daptomycin. Klinisch bedeutsam sind insbesondere MRSA-assoziierte Endokarditis, Bakteriämie/Sepsis, Katheter-assoziierte Blutstrominfektionen, Pneumonie sowie Infektionen von Gelenkprothesen. Vancomycin-resistente Enterokokken betreffen in erster Linie Enterococcus faecium, selten auch Enterococcus faecalis. Die Diagnose von VRE ist nicht selten ein Zufallsbefund als Kolonisator in Wunden aus Haut- und Weichteilinfektionen oder im Rahmen von Screeninguntersuchungen. Klinische Relevanz haben VRE im Rahmen einer Sepsis, der Endokarditis sowie bei intraabdominellen Infektionen.

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Author information

Authors and Affiliations

  1. Division Medizinische Mikrobiologie d. Universitðtsinstituts für Med.-Chem. Labordiagnostik, Paracelsus Medizinische Privatuniversität, Müllner Hauptstr. 48, 5020, Salzburg, Österreich

    Jan Marco Kern

Authors
  1. Jan Marco Kern
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Correspondence to Jan Marco Kern .

Editor information

Editors and Affiliations

  1. Medizinische Klinik I, Universitätsklinikum Schleswig-Hoslstein, Campus Lübeck, Lübeck, Schleswig-Holstein, Germany

    Hendrik Lehnert

  2. TU Dresden Universitätsklinikum Carl Gustav Carus, Dresden, Germany

    Sebastian M. Schellong

  3. FB Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig Medizinische Klinik und Poliklinik II, Leipzig, Sachsen, Germany

    Joachim Mössner

  4. Krankenhaus Barmherzige Brüder, Regensburg, Germany

    Cornel C. Sieber

  5. Nürnberg, Bayern, Germany

    Walter Swoboda

  6. Universitätsklinikum Giessen und Marburg Klinik für Innere Medizin, Marburg, Hessen, Germany

    Andreas Neubauer

  7. Interdisziplinärer Schwerpunkt für Hämos, Universitätsklinikum Gießen und Marburg, Gießen, Germany

    Bettina Kemkes-Matthes

  8. Klinik für Gastroenterologie,Hepatologie, Medizinische Hochschule Hannover, Hannover, Germany

    Michael P. Manns

  9. Sektion für Molekulare und Klinische Inf, Universitätsklinikum Schleswig-Holstein,, Lübeck, Germany

    Jan Rupp

  10. Abt. Kardiologie und Pneumologie, Universitätsklinikum Göttingen Herzzentrum Göttingen, Göttingen, Germany

    Gerd Hasenfuß

  11. Abt. Nephrologie und Klinische Immunologie, Univ.Klinikum Aachen Medizinische Klinik II, Aachen, Germany

    J. Floege

  12. Universitätsklinikum Köln Klinik I für Innere Medizin, Köln, Germany

    Michael Hallek

  13. Klinik für Pneumologie, Medizinische Hochschule Hannover (MHH) Zentrum Innere Medizin, Hannover, Germany

    Tobias Welte

  14. Klinik u. Poliklinik für Innere Medizin, Universitätsmedizin Greifswald, Greifswald, Germany

    Markus Lerch

  15. Dr.-Horst-Schmidt-Kliniken GmbH, Wiesbaden, Germany

    Elisabeth Märker-Hermann

  16. Klinische Toxikologie, Giftinformation, Universitätsklinikum Mainz II. Medizinische Klinik und Poliklinik, Mainz, Germany

    Ludwig Sacha Weilemann

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Kern, J.M. (2015). Multiresistente grampositive Erreger (MRSA, VRE). In: Lehnert, H., et al. SpringerReference Innere Medizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54676-1_549-1

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  • DOI: https://doi.org/10.1007/978-3-642-54676-1_549-1

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  • Online ISBN: 978-3-642-54676-1

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