复杂腹腔感染(1)PPT课件.ppt

复杂腹腔感染
IAI相关指南
the Therapeutic mittee of the Surgical Infection Society,The Surgical Infection Society Guidelines on Antimicrobial Therapy for Intra-Abdominal Infections:An Executive Summary,SURGICAL INFECTIONS Volume 3, Number 3, 2002
IDSA, the Surgical Infection Society, the American Society for Microbiology, and the Society of Infectious Disease Pharmacists,Guidelines for the Selection of Antiinfective Agents plicated Intra-abdominal Infections,CID2003, 37:997–1005
Diagnosis and Management plicated Intra-abdominal Infection in Adults and Children:Guidelines by the Surgical Infection Societyand the Infectious Diseases Society of America;Clinical Infectious Diseases 2010; 50:133–64
Infectious Diseases Society of Taiwan; Taiwan Surgical Society of Gastroenterology,etal,Guidelines for antimicrobial therapy of intra-abdominal infections in adults, J Microbiol Immunol Infect. 2008;41:279-281
腹腔感染(IAI)概述
过去一个世纪IAI治疗取得巨大进步,死亡率显著下降 90% in 1900 to 23% in 2002
IAI不同来源感染的死亡率
appendix (%)
stomach/duodenum (21%)
pancreas (33%)
small bowel (38%)
large bowel (45%)
biliary tract (50%)
JOHN A. WEIGELT, MD,Empiric treatment options in the management plicated intra-abdominal infections, cleveland clinic journal of medicine volume 74 • supplement 4 august 2007
IAI定义分类
f. M. i, p. S. barie,ManageMent of Severe SepSiS of abdoMinal origin, Scandinavian Journal of Surgery 96: 184–196, 2007
单纯腹腔感染
复杂腹腔感染
Intra-abdominal infections also can be categorized as plicated plicated, although the distinction is not always clear
JOHN A. WEIGELT, MD,Empiric treatment options in the management plicated intra-abdominal infections CLEVELAND CLINIC JOURNAL OF MEDICINE VOLUME 74 • SUPPLEMENT 4 AUGUST 2007
plicated IAI
单纯性腹腔感染仅累及1个器官,而且没有解剖结构的破坏
通常病灶可完全切除,仅需预防性使用抗菌药物
Blot S, De Waele JJ. Critical issues in the clinical management plicated intra-abdominal infections. Drugs. 2005;65(12):1611-20
Primary bacterial peritonitis
指腹腔没有破口的自发性腹膜炎
更多见于婴幼儿、肝硬化及免疫抑制的病人
Secondary bacterial