Bacteremia due to Acinetobacter baumannii epidemiology, clinical findings, and prognostic features
Bacteremia due to Acinetobacter baumannii epidemiology, clinical findings, and prognostic features
复制标题
DOI：
10.1093/clinids/22.6.1026
复制
发表时间：
1996-06-01
影响因子：
11.8
通讯作者：
Cobacho, AR
中科院分区：
文献类型：
--
作者：
Cisneros, JM;Reyes, MJ;Cobacho, AR
近年来，鲍曼不动杆菌引起的医院感染数量有所增加。在一项为期 12 个月的研究中，西班牙塞维利亚一家医院收治的每 1,000 名成年人中就有 1.8 次鲍曼不动杆菌菌血症发作。该研究包括 79 名患者。鲍曼不动杆菌菌血症发生在平均 (+/- SD) 住院 18 +/- 20 天后。在所有病例中，感染都是在医院内获得的； 71%是在重症监护室获得的。发现氨苄西林/舒巴坦是对抗鲍曼不动杆菌最有效的药物。菌血症最常见的来源是呼吸道（32 例 [71%]）。 20 名患者 (25%) 患有感染性休克，24 名患者 (30%) 患有弥散性血管内凝血 (DIC)。亚胺培南或氨苄西林/舒巴坦治疗最有效（治愈率分别为 87.5% 和 83%）。 27名患者（34%）的死亡与鲍曼不动杆菌菌血症有关。 DIC 的存在（比值比 [OR] = 116.4；P < .0001）和不适当的抗菌治疗（OR = 15.2；P < .01）与死亡率独立相关。我们的结论是，大多数鲍曼不动杆菌分离株具有多重耐药性，院内鲍曼不动杆菌菌血症可能导致严重的临床疾病，并与高死亡率相关。
The number of nosocomial infections caused by Acinetobacter baumannii has increased in recent years. During a 12-month study, there were 1.8 episodes of A. baumannii bacteremia per 1,000 adults admitted to a hospital in Seville, Spain. Seventy-nine patients were included in the study. A. baumannii bacteremia occurred after a mean (+/- SD) hospitalization of 18 +/- 20 days. In all cases the infections were acquired nosocomially; 71% were acquired in intensive care units. Ampicillin/sulbactam was found to be the most active agent against A. baumannii. The most common source of the bacteremia was the respiratory tract (32 cases [71%]). Twenty patients (25%) had septic shock, and 24 (30%) had disseminated intravascular coagulation (DIC). Treatment with imipenem or ampicillin/sulbactam was most effective (cure rates, 87.5% and 83%, respectively). The deaths of 27 patients (34%) were related to A. baumannii bacteremia. The presence of DIC (odds ratio [OR] = 116.4; P < .0001) and inappropriate antimicrobial treatment (OR = 15.2; P < .01) were independently associated with mortality. We conclude that most A. baumannii isolates are multiresistant and that nosocomial A. baumannii bacteremia may cause severe clinical disease that is associated with a high mortality.