抗生素PPT课件（英文精品）Multidrug resistant organisms（46p）.pptVIP

* * * * * * * * * * * * * * * * * * * * * ?? If ?the ?patient ?attended ?the ?foreign ?healthcare ?facility ?for ?less ?than ?48 ?hours ?or ?as ?a ?day ?patient ?(e.g., ?holiday ?dialysis): ?? ? 3. Any ?patient ?presenting ?to ?an ?acute ?healthcare ?facility ?in ?Ireland ?(includes ?inter‐hospital ?transfers ?within ?Ireland) ?should ?be ?specifically ?questioned ?regarding ?a ?history ?of ?admission ?to ?an ?Irish ?healthcare ?facility ?reporting ?an ?outbreak ?of ?CR ?in ?the ?past ?12 ?months. ?If ?that ?patient ?has ?been ?an ?inpatient ?in ?such ?an ?Irish ?healthcare ?facility ?for ?more ?than ?48 ?hours: ?? If ?the ?patient ?attended ?the ?Irish ?healthcare ?facility ?reporting ?a ?CRE ?outbreak ?for ?less ?than ?48 ?hours ?or ?as ?a ?day ?patient: ?? * * * * * * * * * Infections caused by ESBLs When ESBL-producing strains of E. Coli cause infections More difficult to treat, because of their antibiotic resistance? Typically show greater than average resistance to other antibiotics Treatment with the appropriate antibiotic may be delayed Epidemiology in Ireland Most cases are in the hospital, increasing Increasing in the community esp. in nursing homes Outbreak has been reported in nursing home in Ireland CRE Carbapenem Resistant Enterobacteriaciae Meropenem is a Carbapenem Emergence of bugs (E. coli and Klebsiella species) that produce an enzyme that breaks down Meropenem Why is CRE important? Carbapenems (Meropenem) important antibiotics Activity against resistant organisms eg. ESBLs Brings us a step closer to the challenge of extreme drug resistance Treatment of CRE Even more difficult than ESBLs Resistance to other antibiotics, (aminoglycosides and fluoroquinolones) are frequently present Treatment options limited Epidemiology Updated ?Interim ?National ?Recommendations ?on ?Carbapenem ?Resistant ?Enterobacteriaceae ?(CRE) ?screening ?in ?Acute ?Healthcare ?Facilities ?in ?Ireland, ?July ?6th ?2011 ? Guidance on who should be