150.2 📚 國考版

150.2.0.1 必背 — Major Resistance Mechanisms

1. Enzymatic degradation (β-lactamase)
2. Target modification (mecA for MRSA, vanA for VRE)
3. Efflux / porin (gram negative)
4. Metabolic bypass (VRE D-Ala-D-Lac)

150.2.0.2 必背 — Carbapenemases

• KPC (Klebsiella, US): Ceftazidime-avibactam, Meropenem-vaborbactam, Imipenem-relebactam
• NDM (S Asia): Cefiderocol (only)
• OXA-48 (Mid-East): Ceftazidime-avibactam, Cefiderocol

150.2.0.3 必背 — Empirical for MDR Risk

• ESBL: carbapenem
• CRE / MDR Pseudomonas: CAZ-AVI / cefiderocol / meropenem-vabor
• MDR Acinetobacter: sulbactam-durlobactam (2023) / cefiderocol / colistin
• MRSA: vancomycin / linezolid / daptomycin / ceftaroline

150.2.0.4 必背 — XDR-TB

• BPaL (bedaquiline + pretomanid + linezolid) × 6 mo — 2019 FDA → 2024 WHO first-line

---