Departments of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
J Antimicrob Chemother. 2011 Aug;66(8):1839-46. doi: 10.1093/jac/dkr200. Epub 2011 Jun 8.
To investigate the clinical impact of different genospecies of the Acinetobacter calcoaceticus-Acinetobacter baumannii complex (ACB complex; A. baumannii, Acinetobacter gen. sp. 13TU and Acinetobacter gen. sp. 3) on the severity of bacteraemia.
We retrospectively compared the clinical features and outcomes of patients with bacteraemia caused by A. baumannii, Acinetobacter gen. sp. 13TU or Acinetobacter gen. sp. 3. The genospecies were identified using oligonucleotide array sequence analysis (interspacer sequence), and the clonality of Acinetobacter gen. sp. 13TU and 3 isolates was determined by PFGE analysis.
A total of 215 patients with bacteraemia due to ACB complex were evaluated. Among them, 117 (54.4%) had A. baumannii bacteraemia, 77 (35.8%) had Acinetobacter gen. sp. 13TU bacteraemia and 21 (9.8%) had Acinetobacter gen. sp. 3 bacteraemia. A. baumannii bacteraemia was associated with a higher 14 day mortality rate (P < 0.001), a higher 30 day mortality rate (P < 0.001) and a higher in-hospital mortality rate than bacteraemia due to Acinetobacter gen. sp. 13TU or Acinetobacter gen. sp. 3. Independent prognostic factors for the 30 day mortality included the Charlson co-morbidity index (P < 0.001) and Pitt bacteraemia score (P < 0.001). Bloodstream infection caused by a multidrug-resistant A. baumannii isolate appeared to be associated with a poor outcome (P = 0.069). There was no clonal spread of Acinetobacter gen. sp. 13TU or Acinetobacter gen. sp. 3 during the study period.
Bacteraemia due to multidrug-resistant strains but not A. baumannii per se appears to be associated with poor outcome.
研究不同种的鲍曼不动杆菌-醋酸钙不动杆菌复合体（ACB 复合体；鲍曼不动杆菌、13TU 种属的不动杆菌和 3 种属的不动杆菌）对菌血症严重程度的临床影响。
我们回顾性比较了由鲍曼不动杆菌、13TU 种属的不动杆菌或 3 种属的不动杆菌引起菌血症的患者的临床特征和结局。使用寡核苷酸微阵列序列分析（间隔序列）鉴定种属，通过 PFGE 分析确定 13TU 种属和 3 种属不动杆菌分离株的克隆性。
共评估了 215 例 ACB 复合体菌血症患者。其中，117 例（54.4%）为鲍曼不动杆菌菌血症，77 例（35.8%）为 13TU 种属的不动杆菌菌血症，21 例（9.8%）为 3 种属的不动杆菌菌血症。鲍曼不动杆菌菌血症的 14 天死亡率（P < 0.001）、30 天死亡率（P < 0.001）和院内死亡率均高于 13TU 种属或 3 种属的不动杆菌菌血症。30 天死亡率的独立预后因素包括 Charlson 合并症指数（P < 0.001）和 Pitt 菌血症评分（P < 0.001）。血流感染由多药耐药鲍曼不动杆菌分离株引起似乎与不良结局相关（P = 0.069）。在研究期间，13TU 种属或 3 种属的不动杆菌未发生克隆传播。
由多药耐药株引起的菌血症而不是鲍曼不动杆菌本身似乎与不良结局相关。
