Mellouli A, Maamar B, Bouzakoura F, Messadi A A, Thabet L
Laboratoire de Biologie Médicale et Banque du Sang, Centre de Traumatologie et des Grands Brûlés de Ben Arous, Tunisie.
Faculté de Médecine de Tunis, Tunisie.
Ann Burns Fire Disasters. 2021 Sep 30;34(3):218-225.
Acinetobacter baumannii is a feared pathogen in the burn center due to its opportunistic nature and its multidrug resistance. Our purpose was to study the incidence density of Acinetobacter baumannii colonization and infection and to determine the antibiotic susceptibility of the strains isolated in patients hospitalized in the Trauma and Burn Center Burn Unit in Tunisia. Our retrospective study included 1517 non-repetitive strains of Acinetobacter baumannii, between January 2012 and September 2020, with an average rate of 12.2% of the service's bacterial ecology. The incidence density of Acinetobacter baumannii colonization and infection was 13.7‰ days of in-patient stay and 14.1‰ days of in-patient stay, respectively. A positive and statistically significant correlation between Acinetobacter baumannii colonization and infection (rs=0,7; p=0.005) was noted in our study. The colonization strains were mainly isolated from central catheters (71.2%) and skin swab samples (22.9%). Infections were dominated by bacteremia (47.6%) and respiratory tract infections (25.4%). Bacteremia was microbiologically documented in 53% of cases. The most common source of bacteremia was central catheters (60.8%), skin (22.2%) and respiratory tract (15.5%). The rates of resistance inAcinetobacter baumannii to the antimicrobial agents tested were high: ceftazidime (85.2%), pipéracillin-tazobactam (95.6%), imipenem (95.3%), amikacine (91.1%), ciprofloxacin (93.5%), rifampicin (36.4%) and cotrimoxazole (88.1%). The resistance of colistin was noted in 1.8% of cases.
鲍曼不动杆菌因其机会致病特性和多重耐药性，成为烧伤中心令人恐惧的病原体。我们的目的是研究鲍曼不动杆菌定植和感染的发病密度，并确定在突尼斯创伤与烧伤中心烧伤科住院患者中分离出的菌株的抗生素敏感性。我们的回顾性研究纳入了2012年1月至2020年9月期间1517株非重复性鲍曼不动杆菌菌株，占该科室细菌生态学平均比例的12.2%。鲍曼不动杆菌定植和感染的发病密度分别为每住院日13.7‰和14.1‰。我们的研究发现鲍曼不动杆菌定植与感染之间存在正相关且具有统计学意义（rs = 0.7；p = 0.005）。定植菌株主要从中心静脉导管（71.2%）和皮肤拭子样本（22.9%）中分离得到。感染主要为菌血症（47.6%）和呼吸道感染（25.4%）。53%的菌血症病例有微生物学记录。菌血症最常见的来源是中心静脉导管（60.8%）、皮肤（22.2%）和呼吸道（15.5%）。鲍曼不动杆菌对所测试抗菌药物的耐药率很高：头孢他啶（85.2%）、哌拉西林 - 他唑巴坦（95.6%）、亚胺培南（95.3%）、阿米卡星（91.1%）、环丙沙星（93.5%）、利福平（36.4%）和复方新诺明（88.1%）。黏菌素耐药率为1.8%。
