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[鲍曼不动杆菌感染人类的流行病学及临床特征]

[Epidemiology and clinical features of Acinetobacter baumannii infections in humans].

作者信息

Wisplinghoff Hilmar, Seifert Harald

出版信息

Berl Munch Tierarztl Wochenschr. 2014 Nov-Dec;127(11-12):447-57.

Abstract

Over the past 30 years, Acinetobacter (A.) baumannii has been increasingly recognized as an important human pathogen. In contrast to the "non-baumannii" Acinetobacter spp. which rarely cause diseases in humans, the members of the A. baumannii-group (A. baumannii, A. pittii and A. nosocomialis) are important nosocomial pathogens. A. baumannii itself has been implicated as a causative agent in various severe infections such as bloodstream infections, pneumonia, or meningitis, mainly in immunocompromised patients in the intensive care unit setting. The combination of intrinsic and increasing acquired resistance to various antimicrobial agents often limits the therapeutic options. Currently, none of the available antimicrobial agents with potential activity against Acinetobacter spp. such as, carbapenems, tigecycline, and colistin can be considered uniformly active against all A. baumannii strains. In addition, the incidence of multi- or panresistant A. baumannii-strains is increasing worldwide. Due to the unique combination of high resistance to adverse environmental conditions, the propensity for clonal spread and the extensive resistance to antimicrobial agents, A. baumannii is one of the most important bacterial pathogens of our time.

摘要

在过去30年里,鲍曼不动杆菌已日益被公认为一种重要的人类病原体。与很少在人类中引起疾病的“非鲍曼”不动杆菌属不同,鲍曼不动杆菌组(鲍曼不动杆菌、皮氏不动杆菌和医院不动杆菌)的成员是重要的医院病原体。鲍曼不动杆菌本身已被认为是各种严重感染的病原体,如血流感染、肺炎或脑膜炎,主要发生在重症监护病房环境中的免疫功能低下患者身上。对各种抗菌药物的固有耐药性和不断增加的获得性耐药性相结合,常常限制了治疗选择。目前,没有一种对不动杆菌属具有潜在活性的可用抗菌药物,如碳青霉烯类、替加环素和黏菌素,能被认为对所有鲍曼不动杆菌菌株都具有一致的活性。此外,多重耐药或泛耐药鲍曼不动杆菌菌株的发生率在全球范围内都在上升。由于对不利环境条件具有高耐药性、克隆传播倾向以及对抗菌药物具有广泛耐药性的独特组合,鲍曼不动杆菌是我们这个时代最重要的细菌病原体之一。

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