XDR耐药菌感染的治疗策略.ppt

Antimicrobial activity of antimicrobial agents against Acinetobacter baumannii collected globally between 2004 - 2013  意大利2004-2011年鲍曼不动杆菌敏感性的变化 药物 2004 2005 2006 2007 2008 2009 2010 2011 替加环素 1 1 2 1 2 2 2 1 阿莫西林克拉维酸 ≥64 ≥64 ≥64 ≥64 ≥64 ≥64 ≥64 ≥64 哌拉西林他唑巴坦 ≥256 ≥256 ≥256 ≥256 ≥256 ≥256 ≥256 ≥256 头孢他啶 ≥64 ≥64 ≥64 ≥64 ≥64 ≥64 ≥64 ≥64 头孢曲松 ≥128 ≥128 ≥128 ≥128 ≥128 ≥128 ≥128 ≥128 亚胺培南 ≥32 8 16 16 16 16 16 美罗培南 ≥16 16 ≥16 ≥16 ≥16 ≥16 阿米卡星 ≥128 64 ≥128 ≥128 ≥128 ≥128 ≥128 ≥128 各抗生素对临床分离的鲍曼不动杆菌体外药敏试验中MIC90的值（μg/ml） Probability of target attainment (PTA)of tigecycline by Monte Carlo simulation MICs ≤0.25mg/l 99% MIC of 0.5mg/l: 0% and 67.98% MIC 0.5mg/l: 0 cSSSI cIAI MICs ≤0.5mg/l 100% MIC of 1mg/l: 12.93% and 96.6% MIC 2mg/l: 0 In the absence of new drugs on the horizon, rather than using a single fixed dosing regimen, tigecycline dosing needs to be optimized in order to achieve the desired successful clinical response and to prevent an escalation in drug resistance. Untreatable and hard-to-treat infections from carbapenem-resistant Enterobacteriaceae (CRE) bacteria are on the rise among patients in medical facilities. Almost half of hospital patients who get bloodstream infections from CRE bacteria die from the infection CRE在美国发生率： 肺炎克雷伯菌 11% 大肠埃希菌 2% Proportion of Carbapenems Resistant (R+I) Klebsiella pneumoniae Isolates in EU CHINET 2005～2014 CRE的检出情况 2005-2014年CHINET耐药监测肺炎克雷伯菌碳青霉烯类耐药率（%） 2014年CHINET 11308株克雷伯菌属耐药率（%） Acinetobacter isolates resistant to carbapenems MYSTIC 2004 Countries that have reported an outbreak of carbapenem-resistant Acinetobacter baumannii. Red signifies outbreaks reported before 2006, and yellow signifies outbreaks reported since 2006. 2005-2014年CHINET耐药监测不动杆菌属碳青霉烯类耐药率（%） year %耐药率 2014年CHINET 8769株不动杆菌属(鲍曼不动93.0%)的耐药率（%） * Proportion of Carbapenems Resistant (R+I) Pseudomonas aeruginosa Isolates in EU 2005-2014年CHINET耐药监测铜绿假单胞菌对碳青霉烯类的耐药率（%） 2014年CHINET 7471株铜绿假单胞菌耐药率（%） 2014年CHINET 3418株肠杆菌属细菌耐药率（%） AmpC de-repressors (