《ICU常见的易发感染的疾病及其诊疗思路-M3》.ppt

ICU常见的易发感染的疾病及其诊疗思路 内容提要 ICU常见的易发感染的疾病 ICU获得性感染病原特征 ICU常见的易发感染病原学 ICU常见感染抗生素选择策略 ICU常见感染抗生素应用要点 内容提要 ICU常见的易发感染的疾病 ICU获得性感染病原特征 ICU常见的易发感染病原学 ICU常见感染抗生素选择策略 ICU常见感染抗生素应用要点 ICU 感染患者 感染性疾病诊治 感染的预防与控制 Distribution of Nosocomial Infections by Site in Medical-Surgical ICU in US ICU常见的易发感染的疾病 Pneumonia (often ventilator-associated pneumonia, VAP) Catheter- associated urinary tract infection (UTI) Blood stream infection (BSI) Skin and wound infection Sinusitis Gastrointestinal infection (often with Clostridium difficile) 内容提要 ICU常见的易发感染的疾病 ICU获得性感染病原特征 ICU常见的易发感染病原学 ICU常见感染抗生素选择策略 ICU常见感染抗生素应用要点 ICU感染的病原学 细菌 (G+; G-; 厌氧菌) 不典型细菌 真菌 病毒 etc… Mohnarin 2011 ICU Non-ICU 18 ICUs 18-month study 105 episodes IFIs occurred in 5,561 Patients Candida: 16.5 cases/1,000 admissions Filamentous fungi: 2.3 cases/1,000 admissions Main pathogens in ICU E Enterococcus faecium E E.coli S Staphylococcus aureus K Klebsiella pneumoniae A Acinetobacter baumanii P Pseudomonas aeruginosa E Enterobacter species S Stenotrophomonas maltophilia A Candida albican; Aspergillosis Mohnarin 2009-2011 ICU Non-ICU Mohnarin 2011 ICU Non-ICU铜绿假单胞菌体外药敏比较 Mohnarin 2011 ICU Non-ICU鲍氏不动杆菌体外药敏比较 ICU获得性感染病原特征 G- 60-65%; G+ 35-40%; Fungal 15-25% SEA ESKAPE ICU: non-fermenting Antimicrobial-Resistance organisms in ICU 内容提要 ICU常见的易发感染的疾病 ICU获得性感染病原特征 ICU常见的易发感染病原学 ICU常见感染抗生素选择策略 ICU常见感染抗生素应用要点 The pathogens of common HAI Pneumonia (often ventilator-associated pneumonia, VAP) Catheter- associated urinary tract infection (UTI) Blood stream infection (BSI) Intra-abdominal infection (IAI) Causes of VAP The pathogens of common HAI Pneumonia (often ventilator-associated pneumonia, VAP) Catheter- associated urinary tract infection (UTI) Blood stream infection (BSI) Intra-abdominal infection (IAI) The pathogens of common HAI Pneumonia (often ventilator-associated pneumonia, VAP) Catheter- associated urinary tract infection (UTI) Blood stream infection (BSI) Intra-abdominal infection (IAI) The