抗生素敏感与耐药（英文PPT）ANTIBIOTIC.pptVIP

Antibiotic Resistance ANTIBIOTIC RESISTANCE Infectious Disease Epidemiology Section Office of Public Health Louisiana Dept of Health Hospitals ...Your Taxes at Work... Brief History of Resistance Antibiotic Failures are NOT all due to Resistance Lack of effectiveness in vivo may not be due to bacterial resistance; the antibiotic may not be able to reach the microorganisms: cannot go through blood brain barrier be too toxic at doses required to be effective against targeted microorganisms ... Antibiotics Use Promotes Resistance Resistance Seems to Develop Mostly in the Hospitals Archibald L1997.Antimicrobial resistance in isolates from inpatients and outpatients in the United States: increasing importance of the intensive care unit. Clinical Infectious Diseases. 24(2):211-215 Sustained Antibiotic Use Contributes to Resistance Resistance Seems to Develop Mostly in ICU Project ICARE (Intensive Care Antibiotic Resistance Epidemiology) by CDC and Emory U SPH to collect data on 8 US hospitals: For 8/10 pathogens considered, resistance was higher among in hospital isolates Antibiotic Use in Agriculture Promotes Resistance Chickens fed tet-feed In 1 week intestinal flora ~ entirely tetR organisms ? resistant intestinal bacteria in farm members, not in neighbors within 6months: farm dwellers: 31% weekly fecal samples 80% tetR neighbors: 6.8% resistant bacteria contained transferable plasmids selective pressure by tet-feed extends to human beings in contact with chickens and the feed Levy SB 1976. Changes in intestinal flora of farm personnel after introduction of a tetracycline-supplemented feed on a farm. NEJM295(11):583-8 Which Bacteria ? Bacteria of Concern CDC ABC program (Active Bacterial Core Surveillance): Streptococcus pyogenes (grp A) Streptococcus agalactiae (grp B) Streptococcus pneumoniae Haemophilus influenzae Neisseria meningitidis Enterococci Listeria monocytogenes 8 species of bacteria = 75% of all bacterial isolated: Staphylococcus aureus E