多重耐药细菌的抗生素选择（英文PPT）ExtendingOur Options for Multidrug Resistant .ppt

Dosing Conversion Meropenem in critically ill patients * * For 2008, HH Positive rate:7.19 StE positive rate:14.3 HH nosocomial rate2.91 STE nosocomial rate: 6.13 * Among the 655 patient with a clinically recognized infection, the hospital mortality rate from all causes was statistically greater for infection patients who received inadequate therapy compared to those who received adequate therapy (52.1% versus 23.5%, RR 2.22, CI 1.79 – 2.76). The infection related mortality rate was statistically greater among the inadequate therapy group compared to the patients who received adequate therapy (42% versus 17.1%, RR 2.37, CI 1.83 – 3.08). Multivariate analysis demonstrated that inadequate empiric therapy was the most important risk factor for hospital mortality. Other risk factors include multi-organ system failure, use of vasopressors, malignancy, increasing APACHE II score, and increasing age. * Surgical Site Infections due to MRSA have been shown to result in higher mortality than their MSSA counterparts. Researchers from Duke University evaluated the impact of methicillin resistance on SSI outcomes looking at patients following cardiothoracic, orthopedic, vascular, gynecological, and general surgery procedures with MRSA, MSSA infections and uninfected control patients. Mortality in the 90 day post-op period was significantly higher in patients with a MRSA infection. Almost 21% with an MRSA infection died compared to 7% with MSSA and 2% of uninfected patients. Costs were also significantly higher. The cost of treating an MRSA infection was almost $65,000 compared to $37,000 for MSSA and $21,000 for uninfected patients. * A study was performed in Chicago to measure the medical and societal cost attributable to antimicrobial resistant infection (ARI). Evaluated a random sample of hospitalized patients from the year 2000. Patients with trauma, burns, and OB patients excluded. Medical costs were from the hospital prospective and included length o