吸入性肺炎(同名171)课件.ppt

1、.12.3.4.5.6.7.8.Marik,et al.N Engl J Med.2001;344:6659.10.11.12.13.14.老年重症吸入性肺炎患者进行的病原学和预后指标的研究中，54例痰培养阳性患者中共分离出67株致病菌，占前三位的致病菌是G-肠杆菌、厌氧菌、金葡菌，混合感染占相当比例。Ali A.El-Solh et al.Microbiology of Severe Aspiration Pneumonia in Institutionalized Elderly American Journal of Respiratory and Critical Care Medic

2、ine Vol 167.pp.1650-1654,(2003)15.Ali A.El-Solh et al.Am J Respir Crit Care Med Vol 167.pp 16501654,2003病原菌比例病原菌比例(%)16.Almirall J,et al.Med Clin.2007,29;129(11):424-32.17.Distribution of anaerobic cases in function of functional impairment.An Activity of Daily Living score of 6 indicates that a pat

3、ient is fully functional and independent,and a score of 18 indicates total dependence.Ali A.et al.Am J of Resp and Crit Care Med.2003,167:165018.19.资料可以编辑修改使用资料来源网络，如有侵权联系删除，不负法律责任谢谢感谢您的观看和下载资料仅供参考，实际情况实际分析20.21.22.中国中国1010家教学医院家教学医院大肠杆菌大肠杆菌(包括包括ESBL+)ESBL+)的敏感性变迁（的敏感性变迁（CMSS)CMSS)100%100%38.80%78.4

4、0%71.20%78.40%25.20%93.40%97.80%0.0%20.0%40.0%60.0%80.0%100.0%ImipenemMeropenemCefotaximeCeftazidimeCefepimeCefo/sulbPip/tazCiprofloxacinAmikacin2008200820062006200420042003200323.中国中国10家教学医院家教学医院克雷伯菌克雷伯菌(包括包括ESBL+)的敏感性变迁（的敏感性变迁（CMSS)62%83%86%79%79%56%76%98%98%0.0%20.0%40.0%60.0%80.0%100.0%ImipenemM

5、eropenemCefotaximeCeftazidimeCefepimeCefo/sulPip/tazoCiprofloxacinAmikacin2008200820062006200420042003200324.中国中国1010家教学医院家教学医院绿脓杆菌绿脓杆菌的敏感性变迁（的敏感性变迁（CMSSCMSS）S%70%70%70%70%70%70%76%76%71%71%59%59%66%66%78%78%0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%100.0%ImipenemMeropenemPip/tazoCef/sulb.Cef

6、epimeCeftazidimeCiprofloxacinAmikacin20082006 20042003.25 亚胺培南哌拉西林/他唑巴坦头孢哌酮/舒巴坦头孢吡肟左氧沙星氨苄西林/舒巴坦头孢他啶头孢噻肟ESBLESBL的发生率的发生率32%32%血液标本血液标本23.6%23.6%尿标本尿标本27.8%27.8%呼吸道标本呼吸道标本33%33%.26 亚胺培南哌拉西林/他唑巴坦头孢哌酮/舒巴坦头孢吡肟左氧沙星氨苄西林/舒巴坦头孢他啶头孢噻肟ESBLESBL的发生率的发生率15.3%15.3%血液标本血液标本11.1%11.1%尿标本尿标本24.1%24.1%呼吸道标本呼吸道标本12.6%1

7、2.6%.27 亚胺培南哌拉西林/他唑巴坦头孢哌酮/舒巴坦头孢吡肟左氧沙星氨苄西林/舒巴坦头孢他啶头孢噻肟28.亚胺培南哌拉西林/他唑巴坦头孢哌酮/舒巴坦头孢吡肟左氧沙星替卡西林/棒酸头孢他啶哌拉西林.29 亚胺培南哌拉西林/他唑巴坦头孢哌酮/舒巴坦头孢吡肟左氧沙星替卡西林/棒酸头孢他啶哌拉西林氨苄西林/舒巴坦30.敏感率敏感率(%)Baron EJ,et al.Diagn Microbil Infect Dis.1995;21:141-151*Livermore DM,Mushtag S,James D,et al.Int J Antimicrob Agents 2003;22:14-27.*Livermore教授2003年发表的研究中:198株粪肠球菌对哌拉西林/他唑巴坦的敏感率为96%，氨苄西林98%，美罗培南63%，万古霉素94%31.32.Edmiston CE,et al.Antimicrob Agen Chemother,2004,48:1012101633.Ott SR,Dtsch Med Wochenschr.2006 Mar 24;131(12):624-8.34.35.36.37.38.资料可以编辑修改使用资料来源网络，如有侵权联系删除，不负法律责任谢谢感谢您的观看和下载资料仅供参考，实际情况实际分析