Dizbay M, Altuncekic A, Sezer B Ergut, Ozdemir K, Arman D
Gazi University Faculty of Medicine, Department of Clinical Microbiology and Infectious Diseases, Besevler, Ankara, Turkey.
Int J Antimicrob Agents. 2008 Jul;32(1):29-32. doi: 10.1016/j.ijantimicag.2008.02.016. Epub 2008 Jun 6.
Multidrug-resistant (MDR) Acinetobacter baumannii is one of the most important pathogens in intensive care units related to morbidity and mortality, especially in ventilator-associated pneumonia (VAP). In this study, 80.5% of isolates were MDR. The antimicrobial susceptibilities for 12 different antibiotics of MDR A. baumannii isolated from VAP were tested. Among the MDR A. baumannii isolates, resistance rates were found to be 95.5%, 72.7%, 80.3%, 71.2% and 68.2% for ciprofloxacin, cefepime, imipenem, meropenem and cefoperazone/sulbactam, respectively. Netilmicin resistance was detected in 30.3% of the isolates. Resistance rates for colistin and tigecycline were 0% and 25.8%, respectively. It is obvious that new alternative drugs are needed for the treatment of MDR A. baumannii-related VAP owing to high resistance to carbapenems, quinolones, aminoglycosides and cefoperazone/sulbactam. Although colistin appears to be a good choice, adverse reactions and unavailability of colistin limit its wide usage in Turkey. Tigecycline, which will shortly be introduced commercially in Turkey, is very effective against MDR A. baumannii isolates and shows promising results to solve the problem, however resistance rates should be monitored closely.
多重耐药鲍曼不动杆菌是重症监护病房中与发病率和死亡率相关的最重要病原体之一，尤其是在呼吸机相关性肺炎（VAP）中。在本研究中，80.5%的分离株为多重耐药菌。对从VAP中分离出的多重耐药鲍曼不动杆菌的12种不同抗生素的药敏性进行了检测。在多重耐药鲍曼不动杆菌分离株中，环丙沙星、头孢吡肟、亚胺培南、美罗培南和头孢哌酮/舒巴坦的耐药率分别为95.5%、72.7%、80.3%、71.2%和68.2%。30.3%的分离株检测到对奈替米星耐药。黏菌素和替加环素的耐药率分别为0%和25.8%。由于对碳青霉烯类、喹诺酮类、氨基糖苷类和头孢哌酮/舒巴坦具有高耐药性，显然治疗多重耐药鲍曼不动杆菌相关VAP需要新的替代药物。尽管黏菌素似乎是一个不错的选择，但黏菌素的不良反应和不可用性限制了其在土耳其的广泛使用。替加环素即将在土耳其商业化推出，它对多重耐药鲍曼不动杆菌分离株非常有效，并显示出解决该问题的有希望的结果，然而耐药率应密切监测。
