Kim Yeon-A, Choi Jun Yong, Kim Chang Ki, Kim Chang Oh, Kim Myung Soo, Choi Suk Hoon, Chin Bum Sik, Han Sang Hoon, Lee Han Sung, Choi Hee Kyoung, Jeoung Su Jin, Song Young Goo, Yum Jong Hwa, Yong Dongeun, Lee Kyungwon, Kim June Myung
Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Scand J Infect Dis. 2008;40(3):234-40. doi: 10.1080/00365540701633004. Epub 2007 Sep 7.
The spread of Gram-negative bacilli with acquired metallo-beta-lactamase (MBL) threatens the successful treatment of major nosocomial infections. The objective of this study was to evaluate the differences in the clinical characteristics of bacteremia caused by MBL-producing Acinetobacter species and MBL non-producing isolates. Two retrospective case-control studies were conducted using data on patients with Acinetobacter bacteremia, who were admitted between January 2001 and December 2005 at a 1500-bed, tertiary-care teaching hospital. Case group 1 (n=27) included patients from whom imipenem-resistant Acinetobacter was isolated in blood culture, and case group 2 (n=7) consisted of those patients from group 1 who yielded MBL-producing isolates. The control group (n=41) included patients from whom carbapenem-susceptible Acinetobacter isolates were isolated in blood culture. Multivariate analysis revealed that the independent risk factors for imipenem-resistant Acinetobacter bacteremia were neutropenia and prolonged use of carbapenem. The independent risk factors for MBL-producing Acinetobacter bacteremia were neutropenia and prolonged use of cephalosporins. The results of this study suggest that a prolonged use of cephalosporins may be associated with MBL-producing Acinetobacter bacteremia.
携带获得性金属β-内酰胺酶（MBL）的革兰氏阴性杆菌的传播威胁着主要医院感染的成功治疗。本研究的目的是评估产MBL不动杆菌属菌株和不产MBL菌株引起的菌血症临床特征的差异。利用2001年1月至2005年12月期间在一家拥有1500张床位的三级护理教学医院住院的不动杆菌菌血症患者的数据进行了两项回顾性病例对照研究。病例组1（n = 27）包括血培养中分离出亚胺培南耐药不动杆菌的患者，病例组2（n = 7）由病例组1中分离出产MBL菌株的患者组成。对照组（n = 41）包括血培养中分离出碳青霉烯敏感不动杆菌菌株的患者。多变量分析显示，亚胺培南耐药不动杆菌菌血症的独立危险因素是中性粒细胞减少和碳青霉烯类药物的长期使用。产MBL不动杆菌菌血症的独立危险因素是中性粒细胞减少和头孢菌素的长期使用。本研究结果表明，头孢菌素的长期使用可能与产MBL不动杆菌菌血症有关。
