hospital-acquired infections and antimicrobial ... - ecdc - europa课件

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1、HealthCareAssiciatedInfectionsandAntibioticResistance:anincreasingthreattoPatientSafetyinEuropeAftabJasir,EuropeanCentreforDiseasePreventionandControl(ECDC)Europeanpublichealthmicrobiologytrainingprogram(EUPHEM)ObjectivesofthelectureTolearnandunderstandabout:Basicofantibioticsandresistantamon

2、gbacteriaHealthcareassociatedinfectionsRelevantterminologiesStoryofglory1945Fleming,FloreyandChain5Antibiotics6AntimicrobialdrugsNaturalantibioticsSynthesizedantibiotics7NaturalantibioticsPenicilliumnotatumKnowledgaboutkillingDoweneedtouseantibioticsforkillingofpathogens?8HipreplacementOrgantr

3、ansplantsCancerchemotherapyIntensivecareCareofpretermbabiesModernmedicineisnotpossiblewithouteffectiveantimicrobials10TerminologyAntisepticsTopicalsubstances(e.g.skin)e.g.iodineor70%alcohol“reduce”bacterialload12AntibioticsSelectivelytoxicforbacteriabactericidal(killing)bacteriostatic(growthin

4、hibition)noharmtopatient(???)13Prophylaxis14Minimalinhibitoryconcentration/minimalbactericidalconcentration(MIC/MBC)lowestlevelstoppinggrowth/killinge.g.zoneofinhibitionaroundadisk15MIC/MBC16Mostimportanttargetsinbacteria1.Attackbacterialcellwallsynthesis.2.Interferewithproteinsynthesis.3.In

5、terferencewithnucleicacidsynthesis(RNAandDNA)4.Inhibitionofanessentialmetabolicpathwaythatexistsinthebacteriumbutdoesnotexistinthehost5.Membraneinhibitionordisruptiondoesn'tworktoowellbecauseofthesimilaritiesbetweenandbacterialmembranes.17Drugusage=DrugresistanceBasisofAntibioticResistanceTh

6、eantibioticresistanceisguidedbyGenomicchangesSpreadofRplasmidsorothergeneticelementsamongtheBacteriaDorememberAntibioticsareusedinveterinarymedicineThediscoveryofantibioticresistancewasdiscoveredwithspreadofRplasmidsfromanimalsourcesPlasmidsandTransposonsRTFRdeterminantTn8Tn10Tn9Tn21SuperbugsM

7、ultidrug-resistantacquirednon-susceptibilitytoatleastoneagentinthreeormoreantimicrobialcategoriesExtensivelydrug-resistantnon-susceptibilitytoatleastoneagentinallbuttwoorfewerantimicrobialcategoriesPandrug-resistance(PDR)non-susceptibil