Você está na página 1de 24

-

(Triage and Intensive Care in the Primary are)

..

..,


()


,

,
,

!
!
!
!
..,

?

3 :
- 86%
.., ... .
2007, 4(1): 19-22
- 8 (11 )
, ,
85% ( 37%)
.. , .. . .
2007; 4 (4):16-19
- . 85%
( 2-3 ,
) 7 , 30% - 2 :

..
..,


> 40-50%
(>)
Craig W.A. Diagn Microbiol Infect Dis, 1996

80-100 000 /
45-75 000 /
/2=40

20-30 000 /

1 2 3 4 5 6 7
8 9 10 11

.. . . .


- ?
()
13 30 /

13 /:

2 /
(. 0,68
+/- 0,86)
30 /:
2 /
(. 4,34 +/- 2,06),
50% 4 /,
.

Harrison C.J..et al. Pediatr. Inf. Dis J. 1998; 17

40 /
> >50%,
> 80%

..,


/
: 45 50* // 2
: 90-100* //
-
- 3
- (, )


20-30 //




7:1
(, .) 14:1 (
EC)
..,

(/ + , %)
(-II, 2004-05 .)
4
7



14- N
15=
374

16-
1
3

10

0,
6

0,
3

0, 0, 0 0 0
0 0 0
3
3

, 2006 .

(%)
H. influenzae

.. ,
2006
..,

?

.

, 2010

..,

.
.. 2006-2009, III

.., 2014

Chow AW et al; IDSA clinical guideline for acute


bacterial rhinosinusitis. Clin Infect Dis. 2012;54:e72e112.
Wald ERet al. Clinical guideline for the acute
bacterial sinusitis in children. Pediatrics.
2013;132:e262-e280.
Daneman N, McGeer A, Green K, Low DE; Toronto
Invasive Bacterial Diseases Network. Macrolide
resistance in bacteremic pneumococcal disease:
implications for patient management. Clin Infect Dis.
2006;43:432-438.
Ovetchkine P, Rieder MJ; Canadian Paediatric
Society. Azithromycin use in paediatrics: a practical
overview. Paediatr Child Health. 2013;18:311-316.
Klugman KP, Lonks JR. Hidden epidemic of
macrolide-resistant pneumococci. Emerg Infect Dis.



S.pneumoniae Hadley J.A., Pfaller M.A. Diagnostic Microbiology and Infectious Disease. 2007; 57: 47S54S .

3 .

%
:

505

67

72

55

45

45


,

29
48
49
2003-2007
26,5%
6-15 35,8%
S.
pneumoniae
- 47%
32%,
..,

: , , ,

/:
+
V-, -,
-
: ,
/: ,
,
, ,
: 5 ,

:
( MRSA)

/,
/ :

..,


-1 :
,
-1 / (): -
( MRSA), ..

-2 - ():
, , .. H. influenzae b,
.
-2 / (, ):
, , H. influenzae
b,
-3 , : ,
-3 / : , ,
.,
-, -
..,

:
.. ,
(
MRSA
- MRSA

- , ,
- () ,
( )

..,


2011
( , 2
), /, ,

/
/ : ,
/, 2-3
Thorax - October 2011 Volume 66
Supplement 2


1-
90 // / 90
// 2 ( 4 )
/ : , ,
, 2-3
/ / , ..
.

Bradley et al. Clin Infect Dis. 2011 October 1; 53(7):

..,

- 2011
1-
90 // / 90
// 2 ( 4 )
/ /
, .. .

John S. Bradley et al. Executive Summary: The Management of


Community-Acquired Pneumonia in Infants and Children
Older Than 3 Months of Age: Clinical Practice Guidelines by
the Pediatric Infectious Diseases Society and the Infectious
Diseases Society of America. Clin Infect Dis. 2011 October 1;
53(7): 617630.
..,


E. coli >50% ,
/ - 5-10%
: 100 // /, 50 /
/ /. 7-10

- , , ,



:
, -,
15 27%),
(12 10%)

Ingelfinger JR, and Stapleton FB. N Engl J Med 2014 May 4; [e-pub ahead of print].

..,


(S. aureus, S. albus) - ,
(), ,
+
(S. pyogenes, S. albus) :
:
- / 50 //
- 50 //
- (, - )
, - (S. aureus)
, :
- / 100 // 2-3
-
( )
- 10 / 1 6 .
..,


()
,
48
72 .
.
- ,


-
,
,

..,

- , :
-

-
-
- -
- - - ,
-
-
-

- -3,

..,

-
- 1 30 ..
, / -
: - ,
,
, ,

115:1

AAC Circulation 2007;

-
1 , >4 .
1-2 .
: 2-3 .
,
, ,



Red

Book,
2006., 0-5
42% , 67%
55%

,
2009
..,



(-) ,
,
,



(-3-4, , , ,
, )
- ex consilio.

..,

Você também pode gostar