Echeverría M J, López de Goicoechea M J, Ayarza R, Vecino Y, Lazpita M A, Ibarretxebea A B, Barbier A, Cruz González M, Martínez de la Fuente P
Sección de Microbiología, Hospital de Galdakao, Vizcaya.
Enferm Infecc Microbiol Clin. 1997 Jun-Jul;15(6):319-22.
Acinetobacter sp. is an important cause of nosocomial infections and it is often resistant to many antibiotics. In our hospital it often causes infections in patients on the intensive care unit. The aim of this study was to know the susceptibility of Acinetobacter sp. strains isolated in our hospital.
The in vitro activities of nine antimicrobial agents (ticarcillin, piperacillin, ceftazidime, imipenem, meropenem, gentamicin, tobramycin, amikacin and colistin) and three beta-lactamase inhibitors (sulbactam, clavulanate and tazobactam) against 107 clinical isolates of Acinetobacter baumannii were studied. MICs were determined by a dilution agar method, except for colistin, which we used the disk-diffusion agar method.
Of the antimicrobial agents tested imipenem and colistin were highly active against all isolates (100% susceptibility), meropenem presented good activity (96.3% susceptibility), ticarcillin presented moderated activity (84.1% susceptibility). Most of the strains were resistant to ceftazidime (4.7% susceptibility), piperacillin (3.7% susceptibility) and the aminoglycosides (amikacin 21.5% susceptibility, gentamicin 2.8% susceptibility and tobramycin 4.7% susceptibility). Sulbactam was the most active agent among the beta-lactamase inhibitors studied (CMI90 = 4 micrograms/ml).
Recent trends indicate increasing antimicrobial resistance of Acinetobacter baumannii, posing a serious threat to hospitalized patients. An strict attention to maintain a good housekeeping and control of the environment and of the antimicrobial usage, appears the measures most likely to control the spread of Acinetobacter baumannii in hospitals.
不动杆菌属是医院感染的重要病因，且常常对多种抗生素耐药。在我院，它常导致重症监护病房患者发生感染。本研究的目的是了解我院分离的不动杆菌属菌株的药敏情况。
研究了9种抗菌药物（替卡西林、哌拉西林、头孢他啶、亚胺培南、美罗培南、庆大霉素、妥布霉素、阿米卡星和黏菌素）以及3种β-内酰胺酶抑制剂（舒巴坦、克拉维酸和他唑巴坦）对107株鲍曼不动杆菌临床分离株的体外活性。除黏菌素采用纸片扩散琼脂法外，其余药物的最低抑菌浓度（MIC）通过稀释琼脂法测定。
在所测试的抗菌药物中，亚胺培南和黏菌素对所有分离株均具有高度活性（敏感性100%），美罗培南表现出良好活性（敏感性96.3%），替卡西林表现出中等活性（敏感性84.1%）。大多数菌株对头孢他啶（敏感性4.7%）、哌拉西林（敏感性3.7%）和氨基糖苷类药物（阿米卡星敏感性21.5%、庆大霉素敏感性2.8%、妥布霉素敏感性4.7%）耐药。舒巴坦是所研究的β-内酰胺酶抑制剂中活性最强的药物（90%抑菌浓度=4微克/毫升）。
近期趋势表明鲍曼不动杆菌的耐药性不断增加，对住院患者构成严重威胁。严格注意保持良好的环境卫生以及控制环境和抗菌药物的使用，似乎是控制鲍曼不动杆菌在医院传播的最有可能采取的措施。
