不動桿菌屬感染之流行病學、抗藥性及治療

近年來，不動桿菌屬被認為是造成醫療照護相關感染的致病菌之一，特別是常見於加護病房中，增加了病患的死亡率及社會的經濟負擔。不動桿菌屬中的Acinetobacter calcoaceticus、Acinetobacter baumannii、Acinetobacter nosocomialis以及Acinetobacter pittii因為型態相似，臨床經常稱為Acinetobacter calcoaceticus-baumannii (ACB) complex，它們有不同的基因型，然而，過去常因為無法經由型態上或生化反應區別，直至近來越來越多研究使用分子生物技術，才能得到正確的菌種結果。在ACB complex當中，A. baumannii、A. nosocomialis以及A. pittii三菌種(又稱 A. baumannii complex，ABC)最常自臨床檢驗分離出，感染A. baumannii和其他不動桿菌相比，最常對許多抗生素產生抗藥性，也因此造成較高死亡率。藉由本文，我們將比較這三種常見不動桿菌的流行病學、臨床特徵、臨床結果以及抗生素治療選擇。

關鍵字

鮑氏不動桿菌；不動桿菌屬

並列摘要

In recent years, Acinetobacter have been recognized as a major pathogen of healthcare-associated infections, particularly in the intensive care unit (ICU), and therefore have increased mortality and ecnomic burden. Acinetobacter calcoaceticus, Acinetobacter baumannii, Acinetobacter nosocomialis and Acinetobacter pittii are phenotypically similar and are often reported clinically as A. calcoaceticus-A. baumannii complex (ACB complex). They are genotypically distinct but can hardly be distinguished according to phenotypic or biochemical methods. It was not until recently that studies use molecule methods to identify the Acinetobacter species. Among the ACB complex, A.baumannii, A. nosocomialis and A. pittii are also known as A. baumannii complex (ABC), the most commonly isolated pathogens within this genus in clinical analysis. Infections caused by A. baumannii are associated with much higher mortality because of its frequently antimicrobial resistance compared to the other two species. This review will discuss the epidemiology, clinical characteristics and outcomes, and therapeutic options for the management of Acinectobactor infections.

並列關鍵字

Acinetobacter baumannii ； A. baumannii complex ； Acinetobacter calcoaceticus-A. baumannii complex ； ACB complex ； Acinetobacter nosocomialis Acinetobacter pittii ； Acinetobacter spp.

國際替代計量

不動桿菌屬感染之流行病學、抗藥性及治療

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