严重感染治疗策略邱海波2.pptVIP

非发酵革兰阴性杆菌对三种碳青霉烯的敏感性 G-杆菌耐药对预后的影响 Prospective cohort study. Dec 1996 to Sep 2000 Inpatient surgical wards at a university hosp N=924 pats with GNR infections Outcomes were compared between GNR infections with and without antibiotic res rGNRs: resistant to one or more of the following all aminoglycosides, including amikacin all cephalosporins all carbapenems all fluoroquinolones rGNR:入住ICUMVCRRT抗生素更换住院时间病死率 小 结 ESBL和AmpC是ICU重症感染致病菌耐药的重要原因 三代头胞大量使用是导致G-菌出现ESBL和AmpC 的 主要原因 ESBL和AmpC使ICU重症感染患者的病死率明显增加 近3年, ICU非发酵糖细菌的比例从41.2%升高到47.9%铜绿假单胞菌、不动杆菌属、嗜麦芽窄食单胞菌分别位居1、4、7位 碳青霉烯类抗生素、酶抑制剂制