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΢ҩ̼ùϩ

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̼ùϩ࿹ǿ㣬ǿĦ-أжԦ-øȶԼԵ͵ص㣬ѾΪϸȾҪĿҩ֮һ

̼ùϩ࿹ùؽṹɵһͦ-࿹أ2080ṹùùƣ֮ͬϵԭΪ̼C2C3֮ڲ˫⣬6λһΪʽо֤Ļţʹ໯ͨùϩ˳ʽͬг׵ġǿĿԣԼԦ-ø߶ȵȶԡ

[ҪƷ]

ѾеƷǰϡϡϡ

[ص]

һ

ǰϡϡ϶ԴԡҩԴռнǿĿԣͼʺѿȶԱƷҩǰŨ8mgL-1ʱ90%ϵҪ²϶ͳýǰ2-4ͼʺͬҩԳ˾ϸĿǰϵ2-16̼ͭٵĿǰϵ2-4϶G+Ŀǰ»ǿԳ˾ϸĿǰ£̼ͭٵĿѷǰϡ

Ԧ-øȶ

̼ùϩ鵼ijצ-øExtended-spectrum-lactamasesESBLsȾɫ弰鵼ͷ߾øAmpCøи߶ȶԡɱ-øˮ̼øϩ࿹ҩ

ùؽϵPBPs

PBPϸϸĤĵ׷ӣҲǦ-ðλ̼ùϩPBPϽܶʾǿɱԡǰPBPϣPBP2׺ǿ谭ϸڵĺϳɣʹϸѸͣܽ⣬úܽ־PHֵ5.5-8.5Ӱ졣Ѹ͸λҪPBP2PBP3ܽϡ̼ͭٵPBP׺ΪPBP2PBP1APBP3PBP1BPBP4.

ġڶصĹϵ

ҩյڶأٿڶյɱ࿹ǿڶյ-࿹PBPSõأǰPBP2ֻյڶͷţPBP2PBP3յڶͷˮƽǰϡѪѭڶˮƽѪѧĶйءȻڶصһЩΣصظȾˣѡҩʱӦʵԿǡ

[û]

÷ʽ ̼ùϩ࿹÷ʽưճĺϳøùؽϵףPBPsӶ谭ϸճĺϳɣʹϸȱ𣬾ʹϸ͸ѹıϸܽɱϸ鶯ϸڣܴҩӰ죬ҩжϸѡɱãСʮ֤ʵϸĤ⵰PBPsǴҩðλǰPBPĽϣPBP2׺ǿ谭ϸڵĺϳɣʹϸѸܽ͡⣬úܽ־PH5.58.5Ӱ졣Ѹ͸볦˾ƺ̼ͭٵ߾λҪPBP2PBP3ܽϡ϶ԽϾðλPBP1PBP3Դ󳦸˾ճɳù̼ͭٵ߾ðλΪPBP2.

[ҩ]

  ̼ùϩΪ񿹾㡢ǿһ࿹أԶ֦ªø߶ȶͷ߾ҩԿɷáϸԸҩﲻڽҩԣԸԾԾǿĿԡ

϶ԸԾĿǰ»ǿ϶ԸԾЧϲϿԾǿ俹ԾĻǰϵ216̼ͭٵ߾ҲΪǿǰϵ4֬ϡͷ412ٴ²ⶨϵҩĿԡʾ϶ԶָԾнǿĿԣǿǰϡͷ뿡ͷडɳǡɳǣԴ󳦰ϣײ˾־ؾɳžξɳ׾MIC900.080.25ug/mlǰMIC901/41/16˾˾Ŀǰ൱MIC90Ϊ0.250.5ug/mlѪоMIC90Ϊ0.125ug/mlǰMIC901/16ͷMIC901/4ԸԾòǰϣ4ֿء

[ҩԼ]

µĿҩ֣ǰϸҩԵIJȻĿǰϸ̼ùϩҩ൱ͣԳԭ൱ߣ̼ùϩ-һٴӦú󼴳ҩꡣǰٴӦö꣬ҩľУƵ߾೦ͼùǰҩŧ˾С

ٴҪ²̼ùϩҩټҩҪУ1.ùؽϵ׽½ҪͼijЩ2.ͦ-øˮ̼ùϩ΢Լϸ̼ùϩͨ͸½ҩԲҪһЩ˾ŧ˾3.п-øˮ̼ùϩ࣬ЩΪٴdzIJԭ

[ٴӦ]

̼ùϩ࿹Ҫʹಡˣ

1. ֢ȾԺڻԷסѪ֢ĤԼϸٵķȲˣڲԭȷǰΪ˾ǿܵIJԭΪƵѡҩԭȷɼʹãҲ"".

2. ҩȾƣESBLsꡢAmpCøͬʱESBLsAmpCøĸȾ

3. Ĵͷ߾ؼƼЧϸĸĤססѪ֢ȡ

ǰϣimipenemIMP Ʒ̩ܣǰ-˾1U1鷽оİѪ֢·Ⱦ͸ƸȾЧ95%ϣ֯ǹؽں͸ǻڸȾЧ90%ºȾЧΪ85%ϸ76%-92%.иӦȨ׺ҩƷĤ׵ƣ밢Τá̩ܸҩÿ6120.5g 1.0gͯÿ12.5mg/kg.ҩٶȲ˹죬ҩ500mgʱעʱӦ30-60minϡ

ϣmeropenemMEP Ʒƽ϶԰Ѫ֢άϲȾڵķβȾǻȾĤ׵ȾЧϸҩΪ0.5-1gÿ6-8h1ξΣͯΪÿ6-8h10-20mg/kg.Ĥʱÿ2gÿ8h1ΣԱԼҺдﵽ㹻Ũȡ

ϣpanipenemPAPM Ʒ˱-¡1U1鷽оİѪ֢סβȾŧءȾǻȾĤ׵ȡٴЧʺϸѧЧ80%ϡ˱ҩ0.5gϼƣbidÿ߼2gΣͯ10-20 mg/kgÿ2-4ξΡ

[Ӧ֢]

̼ùϩҩĿ׹㡢ǿԺϵͳȾѪ֢ϵͳȾֳϵͳȾԼȾǻȾƤ֯ȾȶкܺõЧ

1. ҩԱҩеԸ˾ظȾɷ׿ײ󳦰ϣ˾ճɳ׾ȳ˾ϸ̼ͭٵ˾ϸ°Ѫ֢ºȾ׺͸·ȾǻȾǻȾȣ̼ͭٵ¸ȾʱעƳijЩɳҩ

2. ˾ϸȾ֢ߡ

3. ԭδȱݻ֢Ⱦľơ

ǰ/˾ΡʶϰϵͳӦʲϵͳȾϡ-¡Ӧ֤⣬п3ϵϸĤ׻ߡ

[ҩ໥]

˾ǰ1U1ãֹǰڴлԡ¡1U1ıϺãͨ¡СܷڣӶƤʵŨȣϵԡ϶ø IȶԱǰϸ4뱶¡øƼ˾á

[лй]

е̼ùϩ࿹ؾΪˮҩһθҩΪ0.5g1gڴﵽ÷̵ֲҺ֭֯ңǻڣԼҺŨΪѪŨȵ816ԼҺеʣt1/2Ϊ7.4hԵѪУt1/2Ϊ1.0h˥ԼΪ1hԼΪ6075ҪйܼԴռ߾Ϳʹ˥ӳܼ˵ĻӦӦټ

˥ܣǰϡϡϰ˥ھΪԼ1СʱԼΪ60-75%Ҫйܼ˿ҩڻ˥ӳܼ˻߾ӦӦټ͸ʱҩɱ͸Ӧҩ

϶øȶԱǰϺãԴ󲿷ˮ⡢й

[Ӧ]

̼ùϩزӦҪΪġŻ¡ʹкθӦԼѪҺѧϸࡢϸ١ϸ١ϸٵȣһΪܡʹʱɳϵͳԣͷʹʱɥʧ⾷Ρ񾭴ҡȣܲȫߣһ⾷λӦͣҩͬʱ̼ùϩ࿹ؿɵƤȡݿ˵ȹӦ˶Թá

ǰϣ̩ܣҪΪġŻ¡кθӦƤȡ׵ȹӦϸ٣ϸ࣬ѪС٣Ѫתøߣϵͳ֢״շ߿շ﷢ϣƽҪΪƤסӦͷʹѪС࣬ϸ࣬ѪתøAKPLDHߵȣż﷢0.05%Զǰϣʶϰϵͳ֢״ȵزӦʽ٣һ0.1%ϣ˱ҪΪġŻ¡кθӦƤҩȡȵӦ

ݿ˷ʵͣӦע⡣ùࡢͷ߾༰-ҩߣ̼ܶùϩسֽԶҩȫԹӦߣӦñҩ

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ڶԱҩPɷֹĻߡ

[ע]

1. ҩﲻ֢ȾΪԤҩ

2. ҩµϵͳӦ෢ԭʷϵͳ߼ܿԴռ˻δҩߣԭϵͳ߱ӦñҩϵͳȾĻָӦϻʱܹ۲鴤زӦ

3.ܲȫӦñҩʱӦܼ˳̶ȼҩ

[ҩ]

껼ӦñҩʱӦܼ˳̶ȼҩ

Ķ

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