MDR Bacterial Infections Our Treatment Option

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504030201007060504030201001999312000200147.63834200033ESBL by screen test31 33 36 38 382002200320042005200648.641.6 44.2 47.443.842 42 4338 38353230ESBL producing K. pneumoniae200132200229 2820032004342005(28 hospitals, 1998-2008)Ceftazidime%R %R31200650.84035344020072008200746.14033200850.74332urinesputumblood8070605040302010070605040302010040 41 41 41 43 44 45 45 482000200163625442ESBL by screen test48 48 48404043Cefotaxime4120022003200420054351443954434753424820062007200856465546 45605044urinesputumbloodNARST dataUrine Blood SputumUrine Blood Sputum
Definition & Action of KPC, CRKP and CRECRE = carbapenem-resistant or carbapenemase-producingEnterobacteriaceaeCRKP = carbapenem-resistant Klebsiella pneumoniaeKPC = Klebsiella pneumoniae carbapenemaseThe organism can "Pop From one Strain to Another“The organism produces an enzyme that• degrades a very powerful antibiotic• confers low-level carbapenem resistance• is on a transferable genetic element• can pop from one strain to another and potentially fromone species to another and [be transmitted] from personto person and patient to patientKPCs display substantial carbapenem hydrolysis & is only weakly inhibited by clavulanic acid & tazobactamKPCs alone reduce susceptibility to carbapenems, they do not confer resistanceTo achieve full resistance to carbapenems, impaired outer-membrane permeability is often required
Page 1 and 2: MDR Bacterial Infections:Our Treatm
Page 5 and 6: IDSA News: 10 New Antibiotics by 20
Page 7: 60504030201001911102010719992000261
Page 11 and 12: Maria Souli, Irene Galani, Anastasi
Page 13 and 14: Antimicrobial Susceptibility for ND
Page 15 and 16: KPC-p K. pneumoniaeisolate. (USA)Ca
Page 18 and 19: MIC distributions of NDM-1 Enteroba
Page 20 and 21: Drug of Choice for ESBL-producingEn
Page 22 and 23: Antimicrobial Option by Risk Level
Page 24 and 25: In vitro activities of fosfomycin a
Page 26 and 27: 0.5, 1.0, 2.0-gm Human Simulated Pr
Page 28 and 29: FIC Index & InterpretationInterpret
Page 30 and 31: FIC Index of MDR P. aeruginosaStrai
Page 32 and 33: Population PharmacokineticAnalysis
Page 34 and 35: Attenuation of Colistin Bactericida
Page 36 and 37: Pharmacokinetic/Pharmacodynamic Det
Page 38 and 39: Recommended Definite Therapy for Se
Page 40 and 41: Breakpoint Criteria of Vancomycin f
Page 42 and 43: One Gram bid: Enough for Vancomycin
Page 44 and 45: การใชยา vancomycin
Page 46 and 47: ยาขนานอื่น ถ
Page 48 and 49: Early Combination Rx vs. Monotherap
Page 54: Thank youAny Comment?Any Question?

MDR Bacterial Infections Our Treatment Option

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