Nahaichuk Vasyl I, Nazarchuk Oleksandr A, Osadchuk Neonila I, Dmytriiev Dmytro V, Nazarchuk Halyna H
National Pirogov Memorial Medical University, Vinnytsia, Ukraine.
Wiad Lek. 2018;71(3 pt 2):705-709.
Introduction: Clinical strains of A.baumannii are becoming highly important in hospital-acquired infections, especially because of their association with low susceptibility to antibiotics, which requires in-depth study with a prognostic determination of the dynamics of antimicrobial efficacy of antibiotics. The aim was to investigate of prognostic models of aminoglycoside antibiotics effectiveness on the basis of the mathematical analysis of real susceptibility of A.baumannii clinical strains, isolated from patients in BICU.
Materials and methods: In the research there were enrolled 435 patients who had undergone treatment of the 2ndb - 3rd degree burns at the burn department of the Vinnitsa Regional Clinical Hospital N. I. Pirogov during 2011-2016. In total, 222 clinical strains of A.baumannii were isolated in early period after burn trauma before antibiotic therapy. The susceptibility of clinical strains A.baumannii to the gentamicin, tobramycin, amikacin, doxycycline was defined by qualitative disco-diffusion and quantitative double dilution methods.
Results: The results of the study demonstrated a low susceptibility of clinical strains of A.baumannii to the studied aminoglicosides and doxycycline. During 2011-2016 the highest sensitivity of Acinetobacter to gentamicin (65%), tobramycin (68,63%) was estimated in 2015. But determined in 2016-2017 following tendency of susceptibility criteria of Acinetobactergave the possibility to found prognostic decreasing of gentamicin and tobramycin efficacy against this pathogen (less than 50%) in critically ill with burns.
Conclusion: A.baumannii, pathogens of infectious complications in patiens, were characterized by a decrease in sensitivity to gentamycin, tobramycin and amikacin. Despite of low efficacy rate of doxycycline the recovery of its effectiveness against A.baumannii is excepted.
引言：鲍曼不动杆菌临床菌株在医院获得性感染中变得极为重要，尤其是因为它们与对抗生素的低敏感性相关，这需要深入研究以对抗生素抗菌疗效的动态进行预后判定。目的是基于对从重症加强护理病房（BICU）患者中分离出的鲍曼不动杆菌临床菌株实际敏感性的数学分析，研究氨基糖苷类抗生素有效性的预后模型。
材料与方法：本研究纳入了2011年至2016年期间在文尼察地区临床医院N. I. 皮罗戈夫烧伤科接受二度至三度烧伤治疗的435例患者。总共在烧伤创伤后抗生素治疗前的早期分离出222株鲍曼不动杆菌临床菌株。通过定性纸片扩散法和定量双倍稀释法确定鲍曼不动杆菌临床菌株对庆大霉素、妥布霉素、阿米卡星、多西环素的敏感性。
结果：研究结果表明鲍曼不动杆菌临床菌株对所研究的氨基糖苷类药物和多西环素敏感性较低。在2011年至2016年期间，2015年测定不动杆菌对庆大霉素（65%）、妥布霉素（68.63%）的敏感性最高。但在2016年至2017年测定的不动杆菌敏感性标准的以下趋势使得有可能发现庆大霉素和妥布霉素对烧伤重症患者中该病原体的疗效预后降低（低于50%）。
结论：鲍曼不动杆菌是患者感染并发症的病原体，其特点是对庆大霉素、妥布霉素和阿米卡星的敏感性降低。尽管多西环素的有效率较低，但预计其对鲍曼不动杆菌的有效性会恢复。
