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Tierarztl Prax Ausg G Grosstiere Nutztiere 2008; 36(S 01): S05-S10
DOI: 10.1055/s-0038-1624560
Allgemeines
Schattauer GmbH

Wundinfektionen durch methicillinresistente Staphylococcus spp. (MRS) bei Kleintieren und Pferden: klinische Bedeutung, Therapie und Prophylaxe

Wound infections caused by Methicillin-resistant Staphylococcus sp. in small animals and horses: clinical relevance, therapy and prophylaxis
B. Walther
1   Institut für Mikrobiologie und Tierseuchen (geschäftsführender Direktor: Univ.-Prof. Dr. L. H. Wieler) der Freien Universität Berlin
,
A. Lübke-Becker
1   Institut für Mikrobiologie und Tierseuchen (geschäftsführender Direktor: Univ.-Prof. Dr. L. H. Wieler) der Freien Universität Berlin
,
L. H. Wieler
1   Institut für Mikrobiologie und Tierseuchen (geschäftsführender Direktor: Univ.-Prof. Dr. L. H. Wieler) der Freien Universität Berlin
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Publikationsverlauf

Publikationsdatum:
09. Januar 2018 (online)

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Zusammenfassung

In den vergangenen Jahrzehnten erlangten verschiedene Populationen von Staphylococcus sp. multiple Resistenzen durch die Akkumulation vielfältiger Resistenzdeterminanten. Heutzutage besitzen Infektionen durch methicillinresistente Staphylococcus sp. (MRS) weltweit sowohl in der Humanmedizin als auch in zunehmendem Maße in Veterinärmedizin große klinische Relevanz. Seitden frühen siebziger Jahren sind MRS-Infektionen bei Tieren bekannt.Inden letzten Jahren kam es jedoch zu einem deutlichen Anstieg derartiger Berichte. Insbesondere bei Kleintieren und Pferden treten Infektionen durch MRSauf,und zwar vorrangig in Zusammenhang mit nosokomialen Wundinfektionen. Die eindeutige Diagnose einer Infektion mit MRS bereitet zwar heute keine Probleme mehr,doch sind einige wesentliche Punkte zu beachten, weshalb nur erfahrene Diagnostiker mit dieser Thematik beauftragt werden sollten. Die Therapie erfolgt nach Auswertung des Antibiogramms (unabhängigvom Antibiogramm sindalle β-Lactame als resistent einzustufen) und wenn möglich lokal. Auch die Frage nach dem ZoonosecharakteranimalerMRS undden damit verbunden Problembereichen (Hygienemanagement, Haftungsfragen, Sorgfaltspflichten, Einsatz humaner Reservewirkstoffe) tritt zunehmend in den Fokus der öffentlichen Wahrnehmung.

Summary

Overthe last decades, various populations of Staphylococcus sp. have acquired a plethora of resistance factors. Currently, infections caused by methicillin-resistant Staphylococcus sp. (MRS) are the most important clinical problem in human health care facilities and are also increasing at a progressive rate in veterinary medicine. Since the early 1970's MRS infections in animals have been known. However, during the lastyears we have been experiencing an increasingly high number of reports on MRS, especially regarding wound infections of small animals and horses. Although the microbiological diagnosis of MRS is clearlydefined now, some aspects are worth mentioning, thus enforcing diagnosis by experienced personnel only. Clinical infections with MRS can be treated topically (e. g. in superficial, uncomplicated small wounds), but in most cases, systemic antimicrobial therapy is warranted. Therefore, it is mandatory to test the sensitivity of MRS against non-β-lactam in each case. With regard to the zoonotic potential of MRS, it is vital to discuss topics like hygiene management, liability questions, responsibilities and application of last resort agents used in human medicine.

Schlüsselwörter

Resistenz - Antibiogramm - Reserveantibiotika - Zoonose - nosokomiale Infektion

Keywords

Resistance - antibiogram - last resort agents - zoonosis - nosocomial infection
 

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