非发酵菌的耐药现状及其对策青岛修.pptxVIP

非发酵菌的耐药现状及其对策青岛修; 主要非发酵菌种类;74859株G-菌分布情况;;共32家三级医院参加(按拼音字母排序);临床分离致病菌得数量;G-菌分离量前5位分别就是铜绿假单胞菌(30%)、鲍曼不动杆菌(30%)、肺炎克雷伯菌(14%)与大肠埃希菌(9%),嗜麦芽窄食单胞菌(6%);铜绿假单胞菌与不动杆菌严重危及患者生命;如何遏制耐药非发酵菌蔓延趋势？如何应对耐药非发酵菌相关感染？;②确定需要禁用、控制使用或限制使用得抗生素种类及品种;三代头孢菌素与细菌耐药 ;大家学习辛苦了，还是要坚持;亚胺培南用量与耐药得关系;包括耐碳青霉烯类得多重耐药鲍曼不动杆菌呈增多趋势;过度使用;4、抗生素处方多样化 Antibiotic heterogeneity 5、降阶梯 De－escalation 6、短抗生素疗程 Short antibiotic courses 7、PK/PD导向得剂量方案优化 PK/PD optimized dosing;如何遏制耐药非发酵菌蔓延趋势？如何应对耐药非发酵菌相关感染？;Garnacho-Montero J, Garcia-Garmendia JL, Barrero-Almodovar A, Jimenez-Jimenez FJ, Perez-Paredes C, Ortiz-Leyba C、 Impact of adequate antibiotic therapy on the oute of patients admitted to the intensive care unit with sepsis、 Crit Care Med 2003; 31:2742-2751、 Kollef MH, Sherman G, Ward S, Fraser VJ、 Inadequate antimicrobial treatment of infections: a risk factor for hospital mortality among critically ill patients、 Chest 1999; 115:462-474、 Rello J, Gallego M, Mariscal D, Sonora R, Valles J、 The value of routine microbial investigation in ventilator-associated pneumonia、 Am J Respir Crit Care Med 1997; 156:196-200、 Iregui M, Ward S, Sherman G, Fraser VJ, Kollef MH、 Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia、 Chest 2002;122:262-268、 Luna CM, Vujacich P, Niederman MS, Vay C, Gherardi C, Matera J, Jolly EC、 Impact of BAL data on the therapy and oute of ventilator-associated pneumonia、 Chest 1997; 111:676-685、 Leibovici L, Drucker M, Konigsberger H et al、 Septic shock in bacteremic patients: risk factors, features and prognosis、 Scand J Infect Dis 1997; 29:71-75、 Valles J, Rello J, Ochagavia A, Garnacho J, Alcala MA、 munity-acquired bloodstream infection in critically ill adult patients: impact of shock and inappropriate antibiotic therapy on survival、 Chest 2003; 123:1615-1624、 Ibrahim EH, Sherman G, Ward S, Fraser VJ, Kollef MH、 The influence of inadequate antimicrobial treatment of bloodstream infections on patient outes in the ICU se