课件：肺炎简介.ppt

* * * * * * * * * * * * * * * * * * * * * * 资料可以编辑修改使用 资料来源网络，如有侵权联系删除，不负法律责任谢谢 感谢您的观看和下载 资料仅供参考，实际情况实际分析 Resistance Burden in Taiwan SMART 2000 臺灣地區主要的呼吸道致病菌抗藥性 Hsueh PR. Antimicro Agents Chemother 2000 肺炎治療觀念與方法 社區性支氣管肺炎或肺炎 病毒性肺炎 外因性肺炎 病毒感染併發 細菌性性肺炎 院內感染性肺炎 低抵抗力肺炎 症狀治療 體液補充 預防性抗生素? 症狀治療 體液補充 處理併發症 選擇治療性抗生素 典型肺炎: S. pneumoniae H. influenzae Others 非典型肺炎: M. pneumoniae C. pneumoniae Legionella spp. Environmental S. pneumoniae H. influenzae Legionella spp. Enterobacteriae Adenovirus Influenza Parainflu. RSV Chickenpox % % % 常見呼吸道疾病的抗微生物製劑選擇 Penicillin Amoxicillin Amoxi/Clavu- Ampi-/Sulbact- Tetracycline Erythromycin Azithromycin Cefotaxime Cefuroxime Trimeth-/Sulfa- Levofloxacin 肺炎球菌 嗜血桿菌 厭氧菌 GNB 黴漿菌 匹衣菌 Legionella ++ ++ ++ ++ + - +/- ++ ++ + +++ - + +++ +++ + - ++ +++ +++ + +++ ++ ++ +++ +++ + + + + + - + - + +++ +++ + - +/- ++ ++ + ++ - - - - +++ +++ +++ - - - +++ - - - - ++ +++ +++ - - ++ +++ - - - - +++ +++ +++ - - - +++ In vitro Pneumococcal Disease and Pneumococcal Vaccines Epidemiology and Prevention of Vaccine-Preventable Diseases Revised December 2004 Streptococcus pneumoniae Gram-positive bacteria 90 known serotypes Polysaccharide capsule important virulence factor Type-specific antibody is protective Pneumococcal PneumoniaClinical Features Abrupt onset Fever Shaking chills Productive cough Pleuritic chest pain Dyspnea, tachypnea, hypoxia Pneumococcal Pneumonia Estimated 175,000 hospitalized cases per year Up to 36% of adult community-acquired pneumonia and 50% of hospital-acquired pneumonia Common bacterial complication of influenza and measles Case-fatality rate 5%-7%, higher in elderly Pneumococcal Disease Epidemiology Reservoir Human carriers Transmission Respiratory Autoinoculation Temporal pattern Winter–early spring Communicability Unknown Probably as long as  organism in respiratory  secretions Invasive Pneumococcal Disease Incidence by Age Group—1998 *Rate per 100,000 population