感染性疾病的抗微生物相关治疗课件真菌感染的诊断及抗真菌药物应用.pptx

真菌感染的诊断及抗真菌药物应用;真菌感染;医院真菌感染的病原体以念珠菌居多，各临床科室发病率有所不同;内容; CHINET 2012年菌种分布 总株数：1619株，其中9株未完成鉴定；已鉴定共37种;8;静脉高营养;侵袭性念珠菌病的菌种分布 ARTEMIS 1997-2007 (n=197,619) ;20306株酵母菌的分布（％）(ARTEMIS 中国 2001～2009);12;念珠菌病：体外抗菌活性结果;Allergic aspergillosis;15;16;17;18;隐球菌病;脑隐球菌病的易感因素众多;诊断;22;23;24;25; 隐球菌抗原检测;隐球菌荚膜抗原乳胶凝集试验;28;29;30;31;32;33;34;35;36;修订定义的不足之处;38;定义 II – 临床特征;40;Medical Mycology:The Last 50 Years;42;43;Membrane Function Polyenes:  Amphotericin B AmB lipid formulations (ABLC, ABCD, LAmB) Nystatin Liposomal nystatin;两性霉素 B;两性霉素B;两性霉素 B;两性霉素 B;两性霉素B;两性霉素 B;1. Ostrosky-Zeichner et al. Clin Infect Dis. 2003;37:415-425. 2. Bates et al. Clin Infect Dis. 2001;32:686-693.;;Lipid AMB Formulations;氟胞嘧啶;氟胞嘧啶;Indications serious infections caused by susceptible strains of candida and/or cryptococcus Candida septicemia, endocaarditis, urinary tract infections and pulmanary infections Cryptococcus meningitis, pulmanary infections, septicemia, urinary tract infections ;Azoles: Imidazoles and Triazoles for Systemic Use;氟康唑;氟康唑;氟康唑;氟康唑;氟康唑;伊曲康唑;伊曲康唑;伊曲康唑 - Adverse Effects;伊曲康唑;伊曲康唑;伊曲康唑;Triazole Antifungals: Voriconazole, Posaconazole;Triazole Antifungals: Voriconazole, Posaconazole;VoriconazoleSummary of Pharmacokinetics;VoriconazoleTissue Distribution in Animals;Adverse Events;伏立康唑适应症;Kartsonis NA. Presented at the 12th European Congress of Clinical Microbiology and Infectious Diseases. April 24-27, 2002. Milan, Italy. ;The Echinocandins;Echinocandins: Caspofungin and Micafungin;Caspofungin: Broad Spectrum of Activity ;Echinocandins: Caspofungin and Micafungin;Summary and Conclusion;卡泊芬净的适应症;米卡芬净 Micafungin ;阿尼芬净 Anidulafungin;Combination therapyIssues;Conclusions;86;87;What’s the indication for prophylaxis?;预防性抗真菌治疗;90;91;非粒缺患者念珠菌血症的经验性治疗;粒缺患者念珠菌血症的经验性治疗;氟康唑首剂负荷剂量AUC更高，抗菌活性更??;95;先发治疗;97;98;非中性粒细胞减少患者念珠菌血症的治疗;中性粒细胞减少患者念珠菌血症的治疗;101;102;103;104;105;气管支气管曲霉病 ;慢性、腐生性和过敏性曲霉病;108;Three key management principles ;治疗方案;器官移植受者隐球菌脑膜脑炎治疗方案;非HIV感染、非器官移植受者隐球菌脑膜脑炎治疗方案;非中枢