耐药阳性菌感染诊疗思路.ppt

　入院后复查血常规示“白细胞计数?23.1×10E9/L，血小板计数?80×10E9/L”，2次血培养提示“金黄色葡萄球菌（MRSA）”，脑脊液常规及生化示“压力?50mmH2O，白细胞?110个/ul，多核占58%，红细胞?1720个/ul，蛋白?805mg/L”，肺部CT示“左肺下叶炎症考虑，右侧少量胸腔积液”，心超示“二尖瓣前叶瓣体附着稍高回声团，左房粘液瘤？感染性心内膜炎赘生物，二尖瓣轻度返流”，腹部B超示“脾内低回声团，胆囊壁毛糙，肝胰腺未见异常”，诊断“急性细菌性心内膜炎、细菌性脑脓肿、左下肺炎”，心电图、出血热抗体、性病系列、结核抗体、凝血功能、肿瘤系列等检查正常，予头孢地嗪、万古霉素、左氧氟沙星等抗感染治疗 *Of the 724 patients with S. aureus bacteremia, 228 patients had a complicated infection at the time of the initial  hospitalization (some patients had more than 1 site of complicated infection). Fowler VG Jr, Olsen MK, Corey GR, et al. Clinical identifiers of complicated Staphyloc