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Kumar A, et al. Crit Care Med 2006; 34: 1589-1596

30-

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30-

58,7%2=14,05,<0,001

. .. – 2013. - 4. – . 26-40

30-

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P.aeruginosa,

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1

Peleg et al. NEJM 2010; 362:1804

Magiorakos A-P, et al. Clin Microbiol Infect 2012; 18:268-281

non-MDR

MDR– R

1 3

DR–

R 1 , 1-2

– R PDR

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R R R R r S S

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5.

2

-

19301930 1940 1950 1960 1970 19801940 1950 1960 1970 1980 1990 20001990 2000

1962 Quinolones

1962 Streptogramins

1958 Glycopeptides

1952 Macrolides

1950 Aminoglycosides

1949 Chloramphenicol

1949 Tetracyclines

1940 Beta-lactams

1936 Sulfonamides

2002 Glycilcyclines

1999 Oxazolidinones

3

Byl, et al. Clin Infect Dis 1999; 29:60

Byl, et al. Clin Infect Dis 1999; 29:60

, (15% )

Byl, et al. Clin Infect Dis1999; 29:60

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invitro

(R/S),

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in vitro

in vitro

(-)

Enterobacteriaceae

Pseudomonasaeruginosa

Acinetobacterbaumannii

:K.pneumoniae (2011-2012 .)

46,8%

49,6%

70,1%

83,3%

58,2%

66,2%

4,2%

5,4%

87,9%

92,6%

75,9%

87,5%

, , .

: E.coli(2011-2012 .)

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6,0%

68,2%

36,3%

66,7%

71,3%

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)

Escherichia spp.Klebsiella spp.

Enterobacter spp.Citrobacter spp.

Proteus spp.Providencia spp.Morganella spp.

Serratia spp.

Escherichia spp.Klebsiella spp.Serratia spp.

Enterobacter spp.Citrobacter spp.

Proteus spp.Providencia spp.Morganella spp.

:

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R R/ R R

R R/ R R

R RR S

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D

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P.aeruginosa (n=159)

98,1%

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13,2%

35,2%

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67,3%

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94,3%

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0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

P.aeruginosa (n=159)CAZ CIP GEN AMK IMI MEM POL , %

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100,0%100,0%100,0%100,0%

82,3%

88,2%

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100,0%100,0%

P.aeruginosa:

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III

P.aeruginosa

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0%

9,9%

1,1%

37,3%

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27,3%

10,5%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

P.aeruginos

C IV 6

6

30

nonXDR P.aeruginosa XDR P.aeruginosa

10,62

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3,42

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11,87

( 2=10,1; =0,001)2,45

( 2=6,19;=0,013)

A.baumannii

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7,3% 92,7%

32,7% 67,3%

8,9% 91,1%

48,7% 51,3%

41,3% 58,7%

65,4% 34,6%

0% 20% 40% 60% 80% 100%

/

-A.baumannii

10,5% 89,5%

100,0%

61,8% 38,2%

100,0%

100,0%

100,0% 0,0%

25,0% 75,0%

100,0%

2,6% 97,4%

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/

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3. , Kumar A, et al. Crit Care Med 2010; 38: 1773-85Micek S, et al. Antimicrob Agents Chemother 2010; 54: 1742-8Martinez J, et al. Antimicrob Agents Chemother 2010; 54: 3590-6Abad C, et al. Crit Care Care Clin 2011; 27: e1-27

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Masterton RG, et al. Crit Care Clin 2011; 27:149-162

Joung M, et al. Crit Care 2011; 15: R79

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Roberts. Clin Pharmacokinet 2006;45:755-773

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Roberts JA, et al. J Antimicrob Chemother 2009; 64:142-150Li C, et al. Antimicrob Agents Chemother 2007; 51: 1725-1730

0,50,5--1,01,0 88 44--

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Nikasio AM, et al. Antimicrob AgentsChemother 2009; 53:1476-1481

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Chen LF, et al. Med Clin N Am 2011; 95:819-842Craig WA, et al. Crit Care Clin 2011; 27:107-121

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28

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23 (82,1%)Dalfino, et al. Clin Infect Dis 2012; 54: 1720

: +

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),

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