细菌耐药性（英文ppt）antimicrobial

《细菌耐药性（英文ppt）antimicrobial 》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、THEU.S.MEDICINEINSTITUTEFORHEALTHSTUDIESAddressingAntimicrobialResistanceWashington,DCFebruary9,2007DonaldM.Poretz,MD,FACP,FIDSAPlanetEarthMicrobesHumanBeingsNumber5x10316x109MetricTons5x10163x108Replicate20-30minutes20-30yearsMicrobiologyinthe21stcentury:Wh

2、ereareweandwherearewegoing?Washington,DC.AmericanSocietyforMicrobiology;2004.MicrobesHavehad3.5billionyearstoadapttotheenvironmentHaveinventedbothbeta-lactamantibioticsandbeta-lactamaseenzymestoresistthoseantibioticsmorethan2billionyearsagoHavehadcollectiveexpe

3、riencecreatinganddefeatingantibioticsfor20milliontimeslongerthanHomosapienshaveknownantibioticsexistedDonotneedourhelpincreatingantibioticresistanceHumanBeingsCanaffecttherateofspreadofbacterialresistancebyapplyingselectivepressureviaexposuretothethousandsofmet

4、rictonsofantibioticswehaveusedinpatientsandlivestockoverthelasthalfcenturyUnderlyingPrinciplesofAntibioticResistanceGivensufficienttimeanddruguse,antibioticresistancewillemerge.Therearenoantibioticstowhichresistancehasnoteventuallyappeared(PRSPtook25years)Resis

5、tanceisprogressivelyevolvingfromlowlevelsthroughintermediatetohighlevels(IncreasingMICsareamarkerforfutureresistance)Levy,S.NEJM1998;338(19):1376-8UnderlyingPrinciplesofAntibioticResistanceTheuseofantibioticsbyanyonepersonaffectsothersintheextendedaswellasimmed

6、iateenvironment(Housematesofpatientstreatedwithantibioticsforacnehadlargenumbersofdrug-Rfloraontheirskin)Levy,S.NEJM1998;338(19):1376-8UnderlyingPrinciplesofAntibioticResistanceOrganismsthatareresistanttoonedrugarelikelytobecomeresistanttoothers(Fluoroquinolone

7、shaveresistanceemergingamongstrainsthatwereresistanttobothtetracyclineandpenicillin)Onceresistanceappears,itislikelytodeclineslowlyifatall(Multi-drugRE.coliinchickensdespitetheremovalofthedrugselectingforresistance)Levy,S.NEJM1998;338(19):1376-8BellevueHospital

8、-1913RapidDevelopmentofResistancetoNewlyIntroducedAntibacterialAgentsAgentYearofFDAApprovalFirstReportedResistancePenicillin19431940Streptomycin19471947Tetracycline19521956M