Joly-Guillou M L, Bergogne-Berezin E, Vieu J F
Laboratoire de Microbiologie, Hôpital Bichat, Paris.
Presse Med. 1990 Mar 3;19(8):357-61.
The growing number of Acinetobacter strains in hospitals and the rapid increase of their resistance to antibiotics have prompted us to undertake a long-term epidemiological study of this resistance at the Bichat hospital, Paris. Between 1971 and 1984, the resistance of Acinetobacter to antibiotics had already progressed, with only some antibiotics (imipenem, ceftazidime, tobramycin and amikacin) remaining active. During the following 5 years (1984-1988) a study of 1056 strains demonstrated a further increase of resistance and showed how serious the problem was in intensive care units. During the last few years, there has been a considerable increase in the proportion of multiresistant strains, reaching 84 per cent with beta-lactam antibiotics and 64 per cent with aminoglycosides. At present, in most cases the only effective treatment is imipenem, and no antibiotic is active in 5.5 per cent of the cases. Studies of lysotypes, enzymes and phenotypic resistance of bacterial strains completed the epidemiological approach, showing the presence of dominant lysotypes. Two predominant lysotypes are associated with multiresistance of Acinetobacter strains responsible for nosocomial infections.
医院中不动杆菌菌株数量的不断增加及其对抗生素耐药性的迅速上升，促使我们在巴黎比沙医院对这种耐药性进行长期的流行病学研究。1971年至1984年间，不动杆菌对抗生素的耐药性已经有所发展，只有一些抗生素（亚胺培南、头孢他啶、妥布霉素和阿米卡星）仍有活性。在接下来的5年（1984 - 1988年）里，对1056株菌株的研究表明耐药性进一步增加，并显示出该问题在重症监护病房有多严重。在过去几年中，多重耐药菌株的比例大幅增加，对β-内酰胺类抗生素的耐药率达到84%，对氨基糖苷类抗生素的耐药率达到64%。目前，在大多数情况下，唯一有效的治疗方法是亚胺培南，5.5%的病例中没有抗生素有活性。对细菌菌株的溶菌型、酶和表型耐药性的研究完善了流行病学研究方法，显示出存在优势溶菌型。两种主要的溶菌型与导致医院感染的不动杆菌菌株的多重耐药性有关。
