Moultrie Denise, Hawker Jeremy, Cole Shannon
Department of Anesthesia and Operative Services, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
AORN J. 2011 Jul;94(1):27-36. doi: 10.1016/j.aorn.2010.12.026.
Multidrug-resistant (MDR) Acinetobacter infections are occurring at alarming rates in traumatic war injuries. Causative factors have not been specifically identified. We used an integrative review of the literature guided by the Identifying, Organizing, and Synthesizing strategy to identify factors related to MDR Acinetobacter transmission. We identified five major themes of commonality relating to transmission-wound types, risk factors, contributing factors, modes of transmission, and prevention strategies-and we identified studies that should be replicated in military populations. We identified sources of transmission (ie, environment to wound, health care worker to wound) and interventions to reduce or eliminate health care-associated or surgical site MDR Acinetobacter infections (ie, using strict infection control guidelines, appropriate use of antibiotics, notification of infected patients).
多重耐药（MDR）不动杆菌感染在创伤性战争伤中的发生率正以惊人的速度上升。致病因素尚未明确确定。我们采用了以识别、组织和综合策略为指导的文献综合综述，以确定与多重耐药不动杆菌传播相关的因素。我们确定了与传播相关的五个主要共同主题——伤口类型、危险因素、促成因素、传播方式和预防策略——并确定了应在军事人群中重复进行的研究。我们确定了传播来源（即环境到伤口、医护人员到伤口）以及减少或消除与医疗保健相关或手术部位多重耐药不动杆菌感染的干预措施（即使用严格的感染控制指南、合理使用抗生素、通报感染患者）。
