Institute for Medical Microbiology, Immunology and Hygiene, University of Cologne, Goldenfelsstr. 19-21, 50935 Cologne, Germany.
J Infect. 2012 Mar;64(3):282-90. doi: 10.1016/j.jinf.2011.12.008. Epub 2011 Dec 20.
To compare the clinical features and antimicrobial susceptibilities of the clinically most important Acinetobacter species Acinetobacter baumannii, Acinetobacter pittii (formerly Acinetobacter genomic species 3) and Acinetobacter nosocomialis (formerly Acinetobacter genomic species 13TU).
295 Acinetobacter isolates collected prospectively from patients with bloodstream infections (BSI) in 52 US hospitals were identified to species level. Clinical and microbiological features were compared between species.
A. baumannii (63%) was the most prevalent species, followed by A. nosocomialis (21%), and A. pittii (8%). Intravascular catheters (15.3%) and the respiratory tract (12.9%) were the most frequent sources of BSI. A higher overall mortality was observed in patients with A. baumannii BSI than in patients with BSI caused by A. nosocomialis and A. pittii (36.9% vs. 16.4% and 13.0%, resp., p < 0.001). The most active antimicrobial agents as determined by broth microdilution were tigecycline (99.6% of isolates susceptible), colistin (99.3%), amikacin (98.5%), and imipenem (95.2%). 27 isolates (10.0%) were multi-drug resistant, all but one of these were A. baumannii.
About one third of Acinetobacter BSI in our study were caused by A. nosocomialis or A. pittii. Patients with A. baumannii BSI had a less favorable outcome.
比较临床重要的不动杆菌种鲍曼不动杆菌、比菲不动杆菌（原不动杆菌基因组种 3）和医院不动杆菌（原不动杆菌基因组种 13TU）的临床特征和抗菌药物敏感性。
从 52 家美国医院的血流感染（BSI）患者中前瞻性收集了 295 株不动杆菌分离株，进行种水平鉴定。比较了种间的临床和微生物学特征。
鲍曼不动杆菌（63%）最为常见，其次是医院不动杆菌（21%）和比菲不动杆菌（8%）。血管内导管（15.3%）和呼吸道（12.9%）是 BSI 最常见的来源。与医院不动杆菌和比菲不动杆菌引起的 BSI 患者相比，鲍曼不动杆菌 BSI 患者的总体死亡率更高（36.9%比 16.4%和 13.0%，p<0.001）。通过肉汤微量稀释法确定的最有效的抗菌药物为替加环素（99.6%的分离株敏感）、黏菌素（99.3%）、阿米卡星（98.5%）和亚胺培南（95.2%）。27 株（10.0%）为多药耐药菌，其中除 1 株外均为鲍曼不动杆菌。
我们的研究中约三分之一的不动杆菌 BSI 由医院不动杆菌或比菲不动杆菌引起。鲍曼不动杆菌 BSI 患者的预后较差。
