1.临床常见的致病球菌_徐英春.ppt

Beta-溶血链球菌药敏试验 A组：克林霉素、红霉素、青霉素或氨苄西林 B组：吡肟/噻肟/曲松、万古霉素 C组：氯霉素、达托霉素、左氧氟沙星，氧氟沙星，利奈唑胺，喹奴普丁－达福普丁 草绿色链球菌药敏试验 A组：氨苄西林、青霉素 B组：头孢吡肟、头孢噻肟、头孢曲松、万古霉素 C组：氯霉素，克林霉素，红霉素、利奈唑胺 * 耐药性及抗菌治疗 3.卡他莫拉菌： 对β-内酰胺耐药：易产BRO-1, BRO-2 水解青霉素、氨苄西林、阿莫西林 卡他莫拉菌敏感性试验 CLSI推荐肉汤稀释法测试的抗菌药物： 阿莫西林－克拉维酸、 头孢克罗，头孢呋辛、 头孢噻肟、头孢他定、头孢曲松， 阿奇霉素、克拉霉素、红霉素、克林霉素 环丙沙星、左氧氟沙星、 四环素 复方磺胺、氯霉素、利福平 Clinical and Laboratory Standard Institution，2008，M100-s18，Vol 28,No.1 * All invasive medical devices support the development of biofilms. Biofilm is a complex three-dimensional structure that consists of cells, bacteria, and extracellular matrix materials. In this scanning electron micrograph, many bacteria are seen in a matrix of material that also contains a red blood cell. This biofilm developed within 24 hours of catheter insertion. Biofilms may promote development of antimicrobial-resistant infections in several ways: Serving as a nidus for deposition and growth of resistant strains that then are released to cause infection; Creating a permeability barrier to antimicrobial diffusion, so that bacteria imbedded in the biofilm may be exposed to sub-inhibitory concentrations of drug that promotes emergence of resistance; Providing a matrix in which bacteria can exchange resistance factors. Biofilms cannot be prevented but some strategies may decrease the rate at which biofilms are formed and decrease bacterial colonization of biofilms. * * (2) I want to review the trends in last 100 years in problem bacteria in hospitalized patients. That has basicly been 3 trends. First is the streptococcus and staphylococcus problem that occured in this century through 1960s. It was developed better drugs for Staphylococci. Then we saw that emerge of Gram negative bacteria was problems in 1970. Pseudomonas aeruginosa became the worst bacteria in hospitals. Then we began to use more and more cephalosporins to deal with Gram negative bacteria. Then we entered the 3rd phase, which was the re-emerge Gram positive bacteria. Cephalosporins seem to in