Epidemiological Characterization of Pan-drug-Resistant Acinetobacter baumannii Isolated in a Medical Center

汎抗藥性靜止桿菌在某南台灣醫學中心的流行病學特徵

柯仰謦(Yang-Ching Ko) ； 劉建衛(Jien-Wei Liu) ； 劉世豐(Shih-Feng Liu) ； 吳沼漧(Chao-Chien Wu) ； 林孟志(Meng-Chih Lin)

《胸腔醫學》 20卷1期 (2005/02) Pp. 8-16

https://doi.org/10.29806/TM.200502.0002

摘要

前言：這篇研究的目的在了解高雄長庚紀念醫院，汎抗藥性靜止桿菌菌株在約三年來的發生率、特徵和變異性。
方法：這篇研究從2001年1月1日到2003年12月31日止在高雄長庚醫院做回溯性分析。我們利用從病人檢體所採得的相關資料獲得汎抗藥性菌種，再從病人病歷記錄去做分析。
結果：從2807患者身上的靜止桿菌得到49株符合汎抗藥性菌種的診斷，我們再定義出40隻真正的感染性菌株並排除了9隻非感染性菌株。我們發現汎抗藥性菌株的分離率在三年內明顯增加，在2001年的分離率是千分之3.53，2002年為千分之3.84，而在2003年更高達千分之36.07。這樣的個案不只在加護病房發現，在普通病房也相繼出現。且病人中有相當高的比例有合併潛在疾病，廣效性抗生素使用病史和接受侵入性處置。
結論：汎抗藥性靜止桿菌過去三年在本院明顯增加。這篇文章得到的相關數據臨床醫師對這種治療困難且具傳染性的細菌加以注意，儘量減少不必要的抗生素使用和侵入性處置，也對合併多重潛在疾病患者提高警覺。

關鍵字

汎抗藥性靜止桿菌

並列摘要

Background: The aims of this study were to assess the isolation rate, characteristics and diversity of pan-drug-resistant Acinetobacter baumannii (PDRAB) strains over a period of 3 years at Kaohsiung Chang-Gung Memorial hospital.
Methods: A retrospective study was carried out from January 2001 through December 2003 at Kaohsiung Chang Gung Memorial Hospital. We compiled the data from a laboratory database for A. baumannii from patient specimens from any site. The medical records of these patients were subsequently reviewed, and pan-drug-resistant strains were obtained.
Results: A total of 2807 A. baumannii isolates were included, and 49 isolates met the diagnostic criteria for PDRAB. We identified 40 true infectious strains and excluded 9 colonized ones. The isolation rate of PDRAB increased remarkably over time (3.53 per 1000 strains in 2001, 3.84 in 2002, and 36.07 in 2003). The events occurred not only in the intensive care units, but also in the general wards. Compared to the non-PDR A. baumannii patients, the majority of the PDRAB patients had co-morbid illnesses, a previous antibiotics treatment history, or had undergone invasive procedures.
Conclusions: PDRAB infections have been seen increasingly at our hospital over the past few years. The data obtained in this study should alert clinicians to the emergence of a potentially difficult and dangerous organism. In addition, the improper use of antibiotics, invasive medical procedures, and patients with multiple co-morbid illnesses were common in PDRAB infection.

並列關鍵字

Pan-drug-resistant Acinetobacter baumannii