Corbella X, Pujol M, Ayats J, Sendra M, Ardanuy C, Domínguez M A, Liñares J, Ariza J, Gudiol F
Infectious Disease Service, Hospital de Bellvitge, University of Barcelona, Barcelona, Spain.
Clin Infect Dis. 1996 Aug;23(2):329-34. doi: 10.1093/clinids/23.2.329.
Fecal colonization with multiresistant Acinetobacter baumannii was evaluated in 189 consecutive patients in intensive care units (ICUs) during two different 2-month periods (October-November 1993 and May-June 1994). Rectal swabs were obtained weekly from admission to discharge from the ICU. Overall, 77 patients (41%) had multiresistant A. baumannii fecal colonization; colonization was detected in 55 (71%) of the patients within the first week of their ICU stay. Clinical infections due to multiresistant A. baumannii occurred more frequently in patients with fecal colonization than in those without fecal colonization (26% vs. 5%, respectively; P < .001). The reinforcement of isolation measures between study periods reduced both the number of fecal carriers of multiresistant A. baumannii (from 52% to 31%; P < .01) and the number of patients with multiresistant A. baumannii infections (from 17% to 11%; no statistical significance). The digestive tract of ICU patients could be an important epidemiologic reservoir for multiresistant A. baumannii infections in hospital outbreaks. Further prospective studies should be undertaken to define the relative significance of digestive tract colonization compared with other body site colonizations.
在两个不同的为期2个月的时间段（1993年10月至11月和1994年5月至6月），对189例重症监护病房（ICU）的连续患者进行了耐多药鲍曼不动杆菌粪便定植情况的评估。从患者入住ICU至出院，每周采集直肠拭子。总体而言，77例患者（41%）存在耐多药鲍曼不动杆菌粪便定植；其中55例患者（71%）在入住ICU的第一周内就检测到了定植。耐多药鲍曼不动杆菌引起的临床感染在有粪便定植的患者中比在无粪便定植的患者中更频繁发生（分别为26%和5%；P<0.001）。两个研究时间段之间加强隔离措施，既减少了耐多药鲍曼不动杆菌粪便携带者的数量（从52%降至31%；P<0.01），也减少了耐多药鲍曼不动杆菌感染患者的数量（从17%降至11%；无统计学意义）。ICU患者的消化道可能是医院暴发中耐多药鲍曼不动杆菌感染的一个重要流行病学储存库。应开展进一步的前瞻性研究，以确定消化道定植相对于其他身体部位定植的相对重要性。
