《革兰阴性菌耐药折点问题》.pptVIP

CLSI 2008 KPC * 如果用 旧折点 和 碳青霉烯酶筛选试验阳性 如果用 当前折点 和 需要流行病学的需要 进行MHT 进行MHT 为何做 MHT? M100-S22. Comment (23) Page 47. Table 2A Supplemental Tables 2 and 3. Pages 52 and 56. 40 本文档共56页；当前第30页；编辑于星期三\0点2分 本文档共56页；当前第31页；编辑于星期三\0点2分 绿脓杆菌 57 本文档共56页；当前第32页；编辑于星期三\0点2分 Pseudomonas aeruginosa  Breakpoint (MIC μg/ml) Revisions Agent Old (M100-S21) New M100-S221 Susc Int Res Susc Int Res Piperacillin ≤64 - ≥128 ≤16 32-64 ≥128 Piperacillin-tazobactam ≤64/4 - ≥128/4 ≤16/4 32/4-64/4 ≥128/4 Ticarcillin ≤64 - ≥128 ≤16 32-64 ≥128 Ticarcillin-clavulanate ≤64/2 - ≥128/2 ≤16/2 32/2-64/2 ≥128/2 1 Corresponding disk diffusion breakpoints also revised M100-S22. Table 2B-1. Page 63. New! 58 本文档共56页；当前第33页；编辑于星期三\0点2分 Pseudomonas aeruginosa M100-S22. Table 2B-1. Page 63. Dosage comments (3 g every 6 h also for piperacillin and for ticarcillin) 59 本文档共56页；当前第34页；编辑于星期三\0点2分 2012年CLSI 绿脓杆菌折点变化 B Piperacillin-tazobactam ? 21 15–20 ? 14 ? 16/4 32/4–64/4 ? 128/4 (7) Interpretive criteria for piperacillin (alone or with tazobactam) are based on a piperacillin dosage regimen of at least 3 g every 6 h. O Ticarcillin-clavulanic acid ? 24 16–23 ? 15 ? 16/2 32/2–64/2 ? 128/2 (8) Interpretive criteria for ticarcillin (alone or with clavulanate) are based on a ticarcillin dosage regimen of at least 3 g every 6 h. B Doripenem ? 19 16–18 ? 15 ? 2 4 ? 8 (12) Interpretive criteria for doripenem are based on a dosage regimen of 500 mg every 8 h. B Imipenem/ Meropenem ? 19 16–18 ? 15 ? 2 4 ? 8 (13) Interpretive criteria for imipenem and meropenem are based on a dosage regimen of 1 g every 8 h. 本文档共56页；当前第35页；编辑于星期三\0点2分 Section III. Therapy-Related Comments “In cases where specific dosage regimens are important for proper application of breakpoints, the dosage regimen is listed. These dosage regimen comments are not intended for use on individual patient reports.” M100-S22. Instructions. Page 28. New! 60 本文档共56页；当前第36页；编辑于星期三\0点2分 Pseudomonas aeruginosa Penicillins +/- β-lactamase Inhib