世界性细菌的耐药：抗生素的滥用（英文PPT）Misuse of Antibiotics Lecture for Publicppt课件.ppt

Misuse of Antibiotics: The Worldwide Crisis of Resistant Bacterial Infections;What Causes Infections?;;;Diseases Caused by Viruses and Bacteria;How Do We Cure These Infections?;;;Resolution of Acute Bronchitis;Gonzales et al., JAMA, 1997;So Why Do Doctors Give Antibiotics For Viral Infections?;Problems With Improper Use of Antibiotics;HISTORICAL PERSPECTIVE;;;Mechanisms of Resistance;;Chronology of Development of Antibiotic Resistance;Individual Abx Use Individual’s Risk of Resistant -UTI ;Relationship between Personal and Community Antimicrobial Use and Carriage of Resistant Pneumococci, Alaska;Clinical Significance of Antibiotic Resistance;S. aureus;;Emergence of Vancomycin Resistant Enterococci;Development of of Resistance in Gram Positive Pathogens;Antibiotics in Animal Feedrationale;48% of all antibiotics by weight is added to animal feeds to promote growth. Results in low, subtherapeutic levels which are thought to promote resistance. Farm families who own chickens feed tetracycline have an increased incidence of tetracycline resistant fecal flora Chickens at Spanish supermarkets have 90% of cultured campylobacter resistant to quinolones 39% of enterococci in the fecal flora of pigs from the Netherlands is resistant to vancomycin vs 0% in Sweden. (Sweden bans antibiotic additives in animal feed);Cross-resistance Between Growth Promoters and Antibiotics for Human Use;EID 1999; Vol 5;US – New Antibacterial Agents;Waiting Room Poster;“The ravaging epidemic of AIDS has shocked the world…We will face similar catastrophes again…We have too many illusions that we can…govern the remaining vital kingdoms, the microbes, that remain our competitors of last resort for dominion of the planet”;“The development of new antibiotics without having mechanisms to insure their appropriate use is much like supplying your alcoholic patients with a finer brandy.”;National Effort to Curb Unwarranted Antibiotics;;;