177.2 📚 國考版

177.2.0.1 必背 — Stenotrophomonas

• Gram - rod, oxidase neg
• Intrinsic MDR (β-lactam, carbapenem R)
• TMP-SMX 首選
• Minocycline / levofloxacin alt

177.2.0.2 必背 — Burkholderia cepacia complex

• CF chronic + cepacia syndrome
• Lung transplant contraindication (historical)
• TMP-SMX / ceftazidime / mero (AST)

177.2.0.3 必背 — Melioidosis (B. pseudomallei)

• Thailand, N Australia endemic
• Soil + water + monsoon
• DM, alcoholism, CKD 高 risk
• “Great mimicker” — multi-organ abscess + sepsis
• Treatment 2 phases:
  • Intensive: ceftazidime or meropenem IV ≥ 2 wk
  • Eradication: TMP-SMX PO × 12 wk
• 5-25% relapse

177.2.0.4 必背 — Glanders (B. mallei)

• Equine zoonosis, bioterror Category B
• Same Tx as melioidosis

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