药敏试验释义及临床应用（英文版）.pdfVIP

Clinical Application and Interpretation of Antimicrobial Susceptibility Testing Charles W. Stratton, M.D. Vanderbilt University School of Medicine Nashville, Tennessee 1 2 • Case series of 6 patients with pandrug-resistant Gram-negatives • Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa • Resistant to: – Antipseudomonal penicillins, cephalosporins, carbapenems, monobactams, quinolones, aminoglycosides, polymyxins • 4 of 6 patients treated successfully with colistin and beta lactams 3 4 IDSA Position Paper on New Antimicrobial Development • “Bad bugs, no drugs” (2004) – Resistance is rising – The antibiotic pipeline is drying up – Federal policy and action are needed – Recommendations for Congress, FDA, NIAID • “Without innovative public policy and additional financial support, fewer and fewer antibiotics will be available to treat the increasing number of drug- resistant and dangerous microbes that threaten Americans and the global community.” 5 IDSA Position Paper on New Antimicrobial Development • There are 33 recommendations in the report • There has been no commitment, response, or acknowledgement of the recommendations by the pharmaceutical industry, the FDA, or Congress 6 New Resistance Challenges • Community-acquired Methicillin-Resistant Staphylococcus