2014革兰阳性菌感染诊治进展_培训课件.ppt

Methods. To compare the safety and efficacy of linezolid and vancomycin in febrile, neutropenic patients with cancer, we conducted a double-blind, multicenter equivalence study. Eligible patients with proven or suspected infection due to a gram-positive pathogen were randomized to receive linezolid or vancomycin 为了对比利奈唑胺和万古霉素在粒缺伴发热的肿瘤患者中的安全性和疗效，我们进行了双盲、多中心等值研究。合格的确诊或者怀疑阳性菌感染随机分组接受利奈唑胺或万古霉素。 * * 谢谢大家。 * * Changes of antiobiotic resistance of bacteria in China * * * Factors (95% CI) significantly (p#,0.01) associated with MRSA in the final multivariate model were: admission to a long term care settings (2.79–4.46); prescription of antibiotics via a hospital pharmacy (1.30–2.01); age 55+years (3.32–5.63); age 15–54 years (1.23–2.16); and consumption of antimicrobial agent per DDD (defined daily dose) (1.25–1.40） 可以看出MRSA感染的主要高危因素为： 长期住院、处方抗生素、高龄、每日使用抗生素剂量DDD。 那临床常见的MRSA 肺炎和复杂皮肤软组织感染的高危因素又是什么？ * 2014年2月发表在《 临床微生物和感染》杂志上欧洲十年在应用利奈唑胺治疗MRSA cssti启示 这个杂志属于ESCMID协会下的杂志。 * 2014年最新《 临床微生物感染杂志》 四月增刊中提及 cssti感染高危因素 * 2014年2月发表在《 临床微生物和感染》杂志上欧洲十年在应用利奈唑胺治疗MRSA 肺炎启示 这个杂志属于ESCMID协会下的杂志。 * * 这么多高危因素如何应用？光有高危因素及治疗肯定是过度治疗。 不治心里又不踏实。 那临床上如何理解如何应用这些高危因素？ 单独的类固醇治疗和单独的开放窗口敏感率都低于40%，二者联合后将近60%。 Sensitivity for MRSA infection is plotted according to the number of patients with at least one of the four independent risk factors identified in the present study. MRSA感染的敏感性标绘是根据患者数与高危因素个数之间的关系画的。 A closed circle indicates sensitivity and number of patients with at least one of the 4 factors, 黑点儿表示敏感性与病人数（4个高危因素中至少有1个）的关系 an open circle indicates sensitivity and number of patients with at least one of 3 factors, 圆圈表示敏感性与病人数（3个高危因素中至少有1个）的关系 an open square indicates sensitivity and number of patients with at least one of 2 factors, 正方形表示敏感性与病人数（2个高危因素中至少有1个）的关系 and a closed triangle indicates sensitivity and number of patients with only 1 factor. 三角形表示敏感性与病人数（就1个高危因素）的关系 The combinations circumscribed by the ellipse were the best subset of a small group of patients with the highes