CMSS2012总结.ppt N.pptVIP

* * * * * * Tigecycline is a derivative of minocycline and a member of the glycylcycline class of antibiotics. It binds to the 30S ribosomal subunit, inhibiting protein synthesis. Tigecycline is approved by the FDA for the treatment of complicated skin and soft tissue infections, complicated intraabdominal infections and community-acquired pneumonia,including infections caused by methicillin-resistant Staphylococcus. Fosfomycin is a phosphonic acid derivative that irreversibly inhibits bacterial cell wall synthesis. aureus and vancomycin-sensitive Enterococcus fecalis. It also has activity against ESBL producing organisms and MDR A. baumannii Current strategies include colistin, fosfomycin, tigecycline and temocillin. Although in vitro testing suggests strong activity for each of these drugs against a large proportion of carbapenem-resistant strains of Enterobacteriaceae, clinical evaluations do not provide strong evidence for equivalent or improved outcome. the emergence of metallo-β-lactamases in Proteus mirabilis and other members of this group is of great concern. the need for caution and careful assessment of the MIC values before using this drug for bloodstream infections Only one published case report exists for the successful treatment of prostatitis caused by VIM-2-producing P aeruginosa with fosfomycin plus aztreonam. one prospective study has described 11 adults in intensive care who were infected with carbapenem-resistant K pneumoniae and receiving intravenous fosfomycin (2–4 g every 6 h) with other antibiotics * * 中国13家教学医院绿脓杆菌的敏感性变迁（CMSS） CMSS 2012,王辉等,中华医学杂志,2013, No18,1388-1395 * 2012 CMSS：绿脓杆菌的敏感性 CMSS 2012,王辉等,中华医学杂志,2013, No18,1388-1395 * M100-S21与M100-S22相比铜绿假单胞菌折点的改变 抗菌药物 旧折点 (M100-S21) 新折点 (M100-S22) 敏感 中介 耐药 敏感 中介 耐药 多利培南 None ≤2 4 ≥8 亚胺培南 ≤4 8 ≥16 ≤2 4 ≥8 美罗培南 ≤4 8 ≥16 ≤2 4 ≥8 哌拉西林 ≤64 - ≥128 ≤16 32-64 ≥128 哌拉西林/他唑巴坦 ≤64/4 - ≥128/4 ≤16/4 32/4-64/4 ≥128/4 替卡西林 ≤64 - ≥128 ≤16 32-64 ≥128 替卡西林/克拉维酸 ≤64/2 - ≥128/2 ≤16/2 32/2-64/2 ≥128/2