万古霉素-稳可信说课讲解课件.ppt
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1、稳可信团队销售幻灯通用篇,Vancocinpro20101211,MRS在全世界快速蔓延,Vancocinpro20101211,汪复等.2009年中国CHINET细菌耐药性监测.中国感染与化疗杂志 2010;10(5):325-334.,2009中国CHINET2MRSA-52.7%MRCNS-71.7%,MRSA肆虐中国大陆:CHINET 2009,汪复等.2009年中国CHINET细菌耐药性监测.中国感染与化疗杂志 2010;10(5):325-334.,MRSA各大医院检出率,Michael D.Nailor,Jack D.Sobel.Antibiotics for Gram-Posi
2、tive Bacterial Infections:Vancomycin,Teicoplanin,Quinupristin,Oxazolidinones,Daptomycin,Dalbavancin,and Telavancin.Infect Dis Clin N Am,2009,23:965-982,三重杀菌机制是万古霉素持久敏感的基础,2007年ZAAPS研究万古霉素 vs.替考拉宁 vs.利奈唑胺的敏感率,敏感率,Jones RN,et al.ZAAPS International Surveillance Program(2007)for linezolid resistance:re
3、sults from 5591 Gram-positive clinical isolates in 23 countries.Diagnostic Microbiology and Infectious Disease 2009;64:191201.,金黄色葡萄球菌,CHINET 2009万古霉素对MRSA与MRCNS保持100%敏感,Vancocinpro20101211,汪复等.2009年中国CHINET细菌耐药性监测.中国感染与化疗杂志 2010;10(5):325-334.,CHINET 2009:2167株MRSA耐药率,汪复等.2009年中国CHINET细菌耐药性监测.中国感染与
4、化疗杂志 2010;10(5):325-334.,CHINET 2009:1967株MRCNS耐药率,汪复等.2009年中国CHINET细菌耐药性监测.中国感染与化疗杂志 2010;10(5):325-334.,英国与爱尔兰 2001-2007MRSA对万古霉素MIC值稳定,“采用历史数据去检测细微的MIC漂移是会被误导的”Prof.Reynolds presented at ICAAC 2009.,Reynolds R,et al.The Illusion of MIC Creep in MRSA.ICAAC 2009;12-145.,中国 2005-2008金葡菌对万古霉素的MIC值稳定,
5、王辉.北京协和医院.GPRS资料.,万古霉素:抑制细胞壁的合成1,万古霉素:影响细胞膜的通透性1,万古霉素:抑制细菌浆内RNA合成1,50,50,50,30,30,核糖体(mRNA),THFA(四氢叶酸),DHFA(二氢叶酸),细菌细胞,30,1.实用抗感染治疗学主审 戴自英.主编 汪复 张婴元.人民卫生出版社2004年11月第1版.第二篇 第十一章 其他抗菌药物:P400.2.夏梦岩等.细菌对利奈唑胺的耐药机制及检测方法研究进展.微生物与感染 2009;4(3):170-173.3.李娟.利奈唑胺及其耐药机制研究进展.西部医学 2009;21(4):667-668.,单一抑菌机制导致利奈唑胺
6、耐药事件频发,2010年CLSI公布了利奈唑胺耐药折点标准,利奈唑胺耐药金葡菌达到 0.05%,报告时无须复杂的确认流程,新!,Mendes,et al.First Report of cfr-Mediated Resistance to Linezolid in Human Staphylococcal Clinical Isolates Recovered in the United States.Antimicrob。Agents Chemother 2008;52(6):2244-2246.,1999年:三期临床时出现2株LRE1,2000年:利奈唑胺上市,1.Meka VG,et a
7、l.Antimicrobial Resistance to Linezolid.Clinical Infectious Diseases 2004,39:1010-1015.2.Pillai SK,et al.Linezolid Resistance in Staphylococcus aureus:Characterization and Stability of Resistant Phenotype.JID 2002;186:1603-1607.3.Potoski BA,et al.Epidemiological Profile of Linezolid-Resistant Coagul
8、ase-Negative Staphylococci.Clinical Infectious Diseases 2006,43:165-171.4.Kelly S,et al.An outbreak of colonization with linezolid-resistant Staphylococcus epidermidis in an intensive therapy unit.Journal of Antimicrobial Chemotherapy 2008;61:901907.5.Ikeda-Dantsuji Y,et al.Linezolid-resistant Staph
9、ylococcus aureus isolated from 2006 through 2008 at six hospitals in Japan.J Infect Chemother,published online 2010.6.Sanchez Garca M,et al.Clinical Outbreak of Linezolid-Resistant Staphylococcus aureus in an Intensive Care Unit.JAMA 2010;303(22):2260-2264.7.Mazzariol A,et al.Linezolid resistance in
10、 a Staphylococcus haemolyticus strain isolated in an intensive care unit.17th ECCMID/25th ICC,Posters P890.8.Rodriguez-Aranda A,et al.Nosocomial spread of linezolid-resistant Staphylococcus haemolyticus infections in an intensive care unit.Diagnostic Microbiology and Infectious Disease 2009;63:398-4
11、02.9.Gales AC,et al.Emergence of linezolid-resistant Staphylococcus aureus during treatment of pulmonary infection in a patient with cystic fibrosis.International Journal of Antimicrobial Agents 2006;27:300-302.10.Hentschke M,et al.Emergence of Linezolid Resistance in a Methicillin Resistant Staphyl
12、ococcus aureus Strain.Infection 2008;36(1):85-87.11.Calvo J,et al.Linezolid resistance in clinical isolates of Staphylococcus haemolyticus.17th ECCMID/25th ICC,Posters P887.12.Kosowska-Shick K,et al.Diagnostic Microbiology and Infectious Disease 2010;68:34-39.13.Tsiodras S,et al.Linezolid resistance
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