腹腔感染的治疗ppt课件.ppt

* * * * 2010年版指南对于轻中度社区获得性腹腔感染推荐头孢西丁、厄他培南、莫西沙星、替加环素、替卡西林/克拉维酸单药方案，联合方案推荐头孢唑林、头孢呋辛、头孢曲松或头孢噻肟联合甲硝唑以及氟喹诺酮联合甲硝唑；对于重度感染，单药方案推荐亚胺培南/西司他丁、美罗培南、多利培南、哌拉西林/他唑巴坦，联合方案推荐头孢他啶、头孢吡肟联合甲硝唑，氟喹诺酮联合甲硝唑 Clin Microbiol Infect.?2015 Nov 25. pii: S1198-743X(15)00986-6. doi: 10.1016/j.cmi.2015.11.004. [Epub ahead of print] Laboratory?diagnosis,?clinical?management?and?infection?control?of the?infections?caused?by?extensively?drugresistant?gram-negative?bacilli: A?Chinese?consensus?statement. Chinese?XDR?Consensus?Working Group,?Guan X1,?He L2,?Hu B2,?Hu J3,?Huang X4,?Lai G5,?Li Y6,?Liu Y7,?Ni Y8,?Qiu H9,?Shao Z10,?Shi Y11,?Wang M12,?Wang R7,?Wu D13,?Xie C1,?Xu Y14,?Yang F15,?Yu K16,?Yu Y17,?Zhang J15,?Zhuo C6. Author information Abstract Extensively?drug-resistant?gram-negative?bacilli?(XDR-GNB) are defined as bacterial isolates susceptible to two or fewer antimicrobial categories. XDR-GNB mainly occur in Enterobacteriaceae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia. The prevalence of XDR-GNB is on the rise either in China and other countries, posing a major public health threat due to the lack of adequate therapeutic options. A group of?Chinese?clinical?experts, microbiologists and pharmacologists came together to discuss and draft a?consensus?on the?laboratory?diagnosis,clinical?management?and?infection?control?of XDR-GNB?infections. Lists of antimicrobial categories proposed for antimicrobial susceptibility testing are created according to documents from the?Clinical?Laboratory?Standards Institute (CLSI), the European Committee on Antimicrobial Susceptibility Testing (EUCAST) and the United States Food and?Drug?Administration (FDA). Multiple risk factors of XDR-GNB?infections?are analyzed with long-term exposure to extended-spectrum antimicrobials being the most important one. Combination therapeutic regimens are summarized for treatment of XDR-GNB?infections?caused?by different bacteria based on limited?clinical?studies and/or?laboratory?data. Mos