感染病患者多重耐药菌感染风险诊断演示文稿.pptVIP

* Healthcare-associated pneumonia is a relatively new clinical entity that includes a spectrum of adult patients who have a close association with acute-care hospitals or reside in chronic-care settings that increase their risk for pneumonia caused by multidrug-resistant pathogens. Craven DE. What is healthcare-associated pneumonia, and how should it be treated? Curr Opin Infect Dis. 2006;19:153-160. * * Community-Acquired MRSA Although the first strains of penicillin-resistant S aureus were identified from nosocomial isolates in the 1960s, outbreaks of community resistance were first detected in the early 1980s.1,2 In some community settings, MRSA has become the prevalent S aureus isolate, especially from cutaneous cultures. Recent community outbreaks have occurred in high-contact settings (child-care centers, athletic teams) and in some cases settings where traditional risk factors did not appear to be involved.3,4 Recent reports of necrotizing pneumonia associated with community-acquired MRSA containing the Panton-Valentine leukocidin (PVL) gene reaffirm that community-acquired MRSA is not just a cutaneous concern.5 References 1. Naimi TS, LeDell KH, Como-Sabetti K, et al. Comparison of community- and health care-associated methicillin-resistant Staphylococcus aureus infection. JAMA. 2003;290:2976-2984. 2. Zetola N, Francis JS, Nuermberger EL, Bishai WR. Community-acquired methicillin-resistant Staphylococcus aureus: an emerging threat. Lancet Infect Dis. 2005;5:275-286. 3. Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus infections among competitive sports participants—Colorado, Indiana, Pennsylvania, and Los Angeles County, 2000-2003. MMWR Morb Mortal Wkly Rep. 2003;52:793-795. 4. Centers for Disease Control and Prevention. Methicillin-resistant Staphylococcus aureus skin or soft tissue infections in a state prison—Mississippi, 2000. MMWR Morb Mortal Wkly Rep. 2001;50:919-922. 5. Gillet Y, Issartel B, Va