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Transcript of L j Z i b y i h e b j a b k l g l g u o ] j Z f h l j b p...
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12.02.2014
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Kumar A, et al. Crit Care Med 2006; 34: 1589-1596
30-
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P.aeruginosa,
,%
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Peleg et al. NEJM 2010; 362:1804
Magiorakos A-P, et al. Clin Microbiol Infect 2012; 18:268-281
non-MDR
MDR– R
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4.
5.
2
-
19301930 1940 1950 1960 1970 19801940 1950 1960 1970 1980 1990 20001990 2000
1962 Quinolones
1962 Streptogramins
1958 Glycopeptides
1952 Macrolides
1950 Aminoglycosides
1949 Chloramphenicol
1949 Tetracyclines
1940 Beta-lactams
1936 Sulfonamides
2002 Glycilcyclines
1999 Oxazolidinones
3
Byl, et al. Clin Infect Dis 1999; 29:60
Byl, et al. Clin Infect Dis 1999; 29:60
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Byl, et al. Clin Infect Dis1999; 29:60
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(R/S),
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in vitro
in vitro
(-)
Enterobacteriaceae
Pseudomonasaeruginosa
Acinetobacterbaumannii
:K.pneumoniae (2011-2012 .)
46,8%
49,6%
70,1%
83,3%
58,2%
66,2%
4,2%
5,4%
87,9%
92,6%
75,9%
87,5%
, , .
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54,3%
6,0%
68,2%
36,3%
66,7%
71,3%
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– II-III
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Escherichia spp.Klebsiella spp.
Enterobacter spp.Citrobacter spp.
Proteus spp.Providencia spp.Morganella spp.
Serratia spp.
Escherichia spp.Klebsiella spp.Serratia spp.
Enterobacter spp.Citrobacter spp.
Proteus spp.Providencia spp.Morganella spp.
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R R/ R R
R R/ R R
R RR S
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P.aeruginosa (n=159)
98,1%
32,7%
21,4%
17,6%
13,2%
35,2%
5,7%
67,3%
78,6%
64,8%
94,3%
86,8%
82,4%
1,9%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
P.aeruginosa (n=159)CAZ CIP GEN AMK IMI MEM POL , %
1 40,2%2 13,8%3 7,5%4 6,3%5 4,4%6 3,1%7 2,5%8 2,5%9 2,5%
10 1,9%(14 ) 15,2%
CAZ – ; CIP – ; GEN – ; AMK – ; IMI – ;MEM – ; POL – / © . .
P.aeruginosa,
11,8%
100,0%100,0%100,0%
100,0%100,0%100,0%100,0%
82,3%
88,2%
17,7%
100,0%100,0%100,0%100,0%
100,0%100,0%
P.aeruginosa:
XDR (Col-S only):
MDR:
III
P.aeruginosa
19,6%
0%
9,9%
1,1%
37,3%
10,6%
27,3%
10,5%
0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%
P.aeruginos
C IV 6
6
30
nonXDR P.aeruginosa XDR P.aeruginosa
10,62
( 2=7,11; =0,008)
3,42
( 2=8,12; =0,004)
11,87
( 2=10,1; =0,001)2,45
( 2=6,19;=0,013)
A.baumannii
6,0% 94,0%
7,3% 92,7%
32,7% 67,3%
8,9% 91,1%
48,7% 51,3%
41,3% 58,7%
65,4% 34,6%
0% 20% 40% 60% 80% 100%
/
-A.baumannii
10,5% 89,5%
100,0%
61,8% 38,2%
100,0%
100,0%
100,0% 0,0%
25,0% 75,0%
100,0%
2,6% 97,4%
100,0%
100,0%
100,0%
0% 20% 40% 60% 80% 100%
/
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A.baumannii:
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3. , Kumar A, et al. Crit Care Med 2010; 38: 1773-85Micek S, et al. Antimicrob Agents Chemother 2010; 54: 1742-8Martinez J, et al. Antimicrob Agents Chemother 2010; 54: 3590-6Abad C, et al. Crit Care Care Clin 2011; 27: e1-27
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