Lortholary O, Fagon J Y, Buu Hoi A, Mahieu G, Gutmann L
Infect Control Hosp Epidemiol. 1998 Mar;19(3):188-90. doi: 10.1086/647793.
We prospectively studied the value of systematic rectal swabs performed for the detection of colonization and the prediction of infections by Acinetobacter baumanii in 751 consecutive patients admitted to five intensive-care units (ICUs) over an 8-month period. Gastrointestinal tract colonization was found in 8.7% of ICU admissions. The positive and negative predictive values of rectal swabs for the detection of subsequent infection were 17% and 99%, respectively. Sensitivity and specificity were 55% and 93%, respectively. We also determined the comparative values of rectal or nasal swabs and skin cultures for the detection of A baumanii colonization in 25 patients already colonized or infected with A baumanii. The combination of rectal and nasal swabs was positive in 20 (80%) of 25. The results of the present study suggest that detection of gastrointestinal tract A baumanii colonization is not an accurate predictor of subsequent A baumanii infection and that combined rectal and nasal swabs might be used for the detection of A baumanii colonization in ICU patients.
我们前瞻性地研究了在8个月期间对连续入住5个重症监护病房（ICU）的751例患者进行系统性直肠拭子检测鲍曼不动杆菌定植及预测感染的价值。在8.7%的ICU入院患者中发现了胃肠道定植。直肠拭子检测后续感染的阳性预测值和阴性预测值分别为17%和99%。敏感性和特异性分别为55%和93%。我们还确定了在25例已被鲍曼不动杆菌定植或感染的患者中，直肠拭子或鼻拭子与皮肤培养检测鲍曼不动杆菌定植的比较价值。25例患者中，直肠拭子和鼻拭子联合检测有20例（80%）呈阳性。本研究结果表明，检测胃肠道鲍曼不动杆菌定植并非后续鲍曼不动杆菌感染的准确预测指标，直肠拭子和鼻拭子联合检测可用于ICU患者鲍曼不动杆菌定植的检测。
