Falagas M E, Karveli E A, Kelesidis I, Kelesidis T
Alfa Institute of Biomedical Sciences (AIBS), 9 Neapoleos Street, 151 23 Marousi, Athens, Greece.
Eur J Clin Microbiol Infect Dis. 2007 Dec;26(12):857-68. doi: 10.1007/s10096-007-0365-6.
Acinetobacter infections have been attracting increasing attention during recent years because they have become common in hospitalized patients, especially in the intensive care unit (ICU) setting. However, the available literature suggests that the pathogen has another fearful potential; it can cause community-acquired infections. We searched PubMed and the reference lists of the initially identified articles and identified six case series regarding a total of 80 patients with community-acquired Acinetobacter baumannii infections; from these, 51 had pneumonia and 29 had bacteremia. Of these 80 patients, 45 (56%) died of the infection. In addition, we identified 26 case reports regarding 43 patients with community-acquired Acinetobacter infections; from these, 38 had pneumonia, two had meningitis, one had soft-tissue infection, one had ocular infection, and one had native valve endocarditis. Comorbidity was commonly present in patients reported in the case series as well as the case reports, mainly, chronic obstructive pulmonary disease, renal disease, and diabetes mellitus; heavy smoking and excess alcohol consumption were also common. Most of the studies originated from China, Taiwan, and tropical Australia. We also identified 12 retrospective or prospective studies (seven from the Far East, two from Oceania, one from N. Guinea, one from Palestine, and one from USA/Canada) that reported the frequency of community-acquired Acinetobacter infections; the range of isolation of Acinetobacter from patients with community-acquired pneumonia in these studies was 1.3%-25.9%. In conclusion, most community-acquired Acinetobacter infections have been reported from countries with tropical or subtropical climate, and mainly affect patients with some form of comorbidity or are associated with heavy smoking and excess alcohol consumption.
近年来，不动杆菌感染日益受到关注，因为它在住院患者中很常见，尤其是在重症监护病房（ICU）环境中。然而，现有文献表明，这种病原体还有另一个可怕的潜在威胁；它可引起社区获得性感染。我们检索了PubMed以及最初检索到的文章的参考文献列表，确定了6个病例系列，共涉及80例社区获得性鲍曼不动杆菌感染患者；其中，51例患有肺炎，29例患有菌血症。在这80例患者中，45例（56%）死于感染。此外，我们还确定了26例关于43例社区获得性不动杆菌感染患者的病例报告；其中，38例患有肺炎，2例患有脑膜炎，1例患有软组织感染，1例患有眼部感染，1例患有天然瓣膜心内膜炎。病例系列和病例报告中报道的患者通常存在合并症，主要是慢性阻塞性肺疾病、肾病和糖尿病；大量吸烟和过量饮酒也很常见。大多数研究来自中国、台湾和澳大利亚热带地区。我们还确定了12项回顾性或前瞻性研究（7项来自远东地区，2项来自大洋洲，1项来自新几内亚，1项来自巴勒斯坦，1项来自美国/加拿大），这些研究报告了社区获得性不动杆菌感染的发生率；在这些研究中，社区获得性肺炎患者中不动杆菌的分离率为1.3%-25.9%。总之,大多数社区获得性不动杆菌感染报告来自热带或亚热带气候的国家，主要影响有某种合并症的患者，或与大量吸烟和过量饮酒有关。
