Lin S Y, Wong W W, Fung C P, Liu C E, Liu C Y
Department of Medicine, Veterans General Hospital-Taipei, Taiwan.
J Microbiol Immunol Infect. 1998 Jun;31(2):119-24.
Eighty-two cases of Acinetobacter calcoaceticus-baumannii complex bacteremia were identified during a 33-month period, from November 1993 to July 1996, at the Veterans General Hospital, Taipei. All cases were due to hospital-acquired infections, with 28 cases of polymicrobial bacteremia. Most patients had severe debilitating conditions: 26 had malignancies, 40 required stay in Intensive Care Unit and 17 had undergone major operations. The main predisposing factors included central venous catheterization, endotracheal intubation or tracheostomy, prior antibiotic therapy and prolonged hospitalization. Amikacin, tobramycin, and ceftazidime were the most effective agents in vitro against A. calcoaceticus-baumannii complex. 32 patients (39 %) died during hospitalization, 19 of the cases (23 %) directly attributed to septicemia. Factors that adversely influenced mortality included polymicrobial bacteremia, inappropriate antimicrobial therapy and prior antibiotic treatment. Of particular interest is the fact that none of the patients who did not receive appropriate antimicrobial therapy survived. Early diagnosis and appropriate antibiotic therapy are critical for improving the prognosis of A. calcoaceticus-baumannii complex bacteremia.
1993年11月至1996年7月的33个月期间，台北荣民总医院共确诊82例醋酸钙不动杆菌-鲍曼不动杆菌复合菌血症病例。所有病例均为医院获得性感染，其中28例为多微生物菌血症。大多数患者病情严重：26例患有恶性肿瘤，40例需要入住重症监护病房，17例接受了大手术。主要诱发因素包括中心静脉置管、气管插管或气管切开、先前的抗生素治疗以及长期住院。阿米卡星、妥布霉素和头孢他啶是体外对醋酸钙不动杆菌-鲍曼不动杆菌复合菌最有效的药物。32例患者（39%）在住院期间死亡，其中19例（23%）直接死于败血症。对死亡率产生不利影响的因素包括多微生物菌血症、不适当的抗菌治疗和先前的抗生素治疗。特别值得注意的是，未接受适当抗菌治疗的患者无一存活。早期诊断和适当的抗生素治疗对于改善醋酸钙不动杆菌-鲍曼不动杆菌复合菌血症的预后至关重要。
