(精选)Antibiotic Pressure and Resistance in Bacteria教学课件.pptVIP

Antibiotic Pressure and Resistance in Bacteria Sarmistha B. Hauger M.D. Director, Pediatric Infectious Disease Children’s Hospital of Austin Austin, Texas TDH CA-MRSA Conference September, 2004 Antibiotic Pressure and Resistance in Bacteria What is it and why is it important? How extensive is it? How does it happen? What factors promote the spread of resistant bacteria ? How does it pertain to the development of CA-MRSA infections? What can HCW do to curb this trend? Antibiotic Pressure and Resistance in BacteriaWhat is it ? ”Selection pressure of antibiotics has led to the emergence of antibiotic-resistant bacteria.” Antibiotics can effect bacteria unrelated to the targeted infectious agent; these may be “normal” flora, leading to the emergence of resistant mutants inhabiting the same environment. Baquero et al., International Report 1996;23:819 Antibiotic Pressure and Resistance in BacteriaWhy is it important? Antibiotic resistance has developed in almost all classes of bacteria of pathogenic potential. Resistance in organisms of low virulence can emerge as important pathogens. The development of resistant bacteria has driven pharmaceutical research to develop more potent, broad-spectrum antibiotics. Use of these in turn, has fueled the appearance of bacteria with newer modes of resistance. Antibiotic Pressure and Resistance in BacteriaWhy is it important? Infections with resistant bacteria occur in health care settings AND the community. Examples of hospital setting: MDR Gram neg, MRSA, VRE Examples of community : MRSA, PRSP, Pcn R Quin R N. gonorrhea, antibiotic resistant Salmonella and Shigella Emergence of Antibiotic-Resistant Bacteria Cohen; Science 1992;257:1050 Gram-negative rods Enterococcus sp. N. gonorrhoeae H. influenzae M. catarrhalis S. pneumoniae 1950 1960 1970 1980 1990 S aureus Penicillin Ampicillin 3rd gen Cephalosporins Quinolones Percentage of Laboratory Isolates Resistant to Antibiotics, Texas Percentage How extensive is the pr