(精选)New template 课件 new logo教学课件.pptVIP

Mucoid Streptococcus pneumoniae on a blood agar plate. Brain with inflammatory exudate covering the cortical hemispheres in purulent meningitis. Courtesy of Dr M Tolnay, University of Basel, Switzerland. 3 4 Black S, Shinefield H. Pediatr Ann. 1997;26:355-360. Group Rate of carriage (%) Preschool children Up to 60 Grammar school children 35 High school students 25 Adults with children inhousehold 18–29 Adults without children in household 6 Carriage Rates Antibiotic resistance Papua New Guinea: First reports of pc resistance in 1969 - Pc resistance 30% already in 1980 South Africa: First reports of multi-resistance in 1977 - Currently pc resistance ~40% Alaska: Pc resistance 25% in 1987 Spain: Pc resistance 7% in 1979 and 46% in 1993 Streptococcus pneumoniae: patterns of penicillin non-susceptibility Major resistance trends by serotype Most frequently associated non-susceptible serotypes: 6B, 9V, 14, 19A, 19F, and 23F Penicillin-susceptible strains may acquire resistance over time and become resistant to penicillin and other classes of drugs Non-susceptible serotypes vary geographically over time, by antibiotic usage, age, and crowding Non-susceptible strains are often resistant to other classes of antibiotics Sales of antibiotics in the EU Cars O. et al. The Lancet 2001:357 ;1851-2 / Data provided by IMS 0 5 10 15 20 25 30 35 40 F rance Spain P o r tugal B elgium Luxem Italy Greece Finland Ireland UK Austria Germany Sweden Denmark Netherland Others* Macrolides and lincosamides Quinolones Trimethoprim Tetracyclines Cephalosporins Penicillinase-resistant penicillins Narrow-spectrum penicillins Broad- spectrum penicillins *Includes sulphonamides, penicillinase-resistant penicillins, amphenicols, aminoglycosides, and glycopeptides. Defined daily dose per 1000 inhabitants per day Penicillin-resistant pneumococci MIC (Mg/L) S (susceptible) 0.06 I (intermediate) 0.12-1.0 R (resistant) 2.0 Reportable in Sweden 0.5 Antibiotic usage