美国CDC关于医疗机构多重耐药菌管理的指南中对多重耐药菌的定义如下：
MDRO definition. For epidemiologic purposes, MDROs are defined as microorganisms, predominantly bacteria, that are resistant to one or more classes of antimicrobial agents (1). Although the names of certain MDROs describe resistance to only one agent (e.g., MRSA,
VRE), these pathogens are frequently resistant to most available antimicrobial agents . These highly resistant organisms deserve special attention in healthcare facilities (2). In
addition to MRSA and VRE, certain GNB, including those producing extended spectrum beta-lactamases (ESBLs) and others that are resistant to multiple classes of antimicrobial
agents, are of particular concern.In addition to Escherichia coli and Klebsiella pneumoniae, these include strains of Acinetobacter baumannii resistant to all antimicrobial agents, or all except imipenem,(6-12), and organisms such as Stenotrophomonas maltophilia (12-14), Burkholderia cepacia (15, 16), and Ralstonia pickettii(17) that are intrinsically resistant to the broadest-spectrum antimicrobial agents. In some residential settings (e.g., LTCFs), it is important to control multidrug-resistant S. pneumoniae (MDRSP) that are resistant to penicillin and other broad-spectrum agents such as macrolides and fluroquinolones (18, 19). Strains of S. aureus that have intermediate susceptibility or are resistant to vancomycin (i.e., vancomycin-intermediate S. aureus [VISA], vancomycin-resistant S. aureus [VRSA]) (20-30) have affected specific populations, such as emodialysis patients.
简单来说就是：对一类以上的抗菌药物耐药的细菌（除结核杆菌），并且通常对除一两种抗菌药物敏感外，对其它所有抗菌药物耐药（如MRSA、VRE、产ESBLs的细菌等）。应该特别关注MRSA、VRE、产ESBLs的细菌以及其它对多种抗菌药物耐药的细菌，包括大肠埃希菌、肺炎克雷柏菌，对所有抗菌药物耐药的鲍曼不动杆菌，和那些对广谱抗菌药物天然耐药的细菌如嗜麦芽寡氧单胞菌、洋葱伯克霍尔德菌等。另外，控制对青霉素和其它广谱抗菌素如大环内酯类和氟喹诺酮类耐药的多重耐药肺炎链球菌也是很重要的。
可参考该贴：https://bbs.sific.com.cn/viewthread.php?tid=1133&extra=page%3D1
[ 本帖最后由 create_qiao 于 2009-1-22 13:02 编辑 ] |
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