儿童泛耐药鲍氏不动杆菌重症感染1例

One case of severe infection by pan-drug resistant Acinetobacter baumannii in children

目的探讨鲍氏不动杆菌(ABA)的生物学及流行病学特点、感染及耐药现状以及泛耐药菌株的治疗及预防。方法对2010年9月确诊的1例急性混合细胞白血病患儿,化疗后骨髓抑制期间合并重症泛耐药鲍氏不动杆菌(PDRAB)感染病例资料进行分析,并复习相关文献。结果 ABA为主要的医院感染致病菌,主要发生在ICU及存在肿瘤、化疗等因素导致免疫力低下的特定患者,临床中ABA耐药问题日臻严重,甚至对碳青霉烯类抗菌药物也逐渐产生耐药,成为全世界医疗工作者遇到的一大难题。结论 PDRAB感染预后较差,控制感染的首要措施在于预防,应尽量减少医院环境的污染,采用目前较少应用的抗菌药物如多黏菌素、替加环素等治疗泛耐药菌株感染。

OBJECTIVE To investigate the biological and epidemiological characteristics, the current status of infection, the therapy and precaution of Acinetobacter baumannii. METHODS One case of leukemic child with bone marrow suppression suffered from severe infection induced by pan-resistant A. baumannii was retrospectively analyzed in combination with literature review. RESULTS A. baumannii had become a significant nosocomial pathogen in recent years. The infections most commonly occured in intensive care unit and in immunocompromised patients with tumor, chemotherapy and other factors. The status of pan-resistant of A. baumannii was getting more and more serious in clinical practice. The incidence of carbapenem-resistant A. baumannii was rising rapidly, which has become a major challenge in the world. CONCLUSION Patients with pan-resistant bacteria infection have a poor prognosis. Primary measures should focus on reinforcing standard infection control procedures and precautions. It is suggested to apply polymyxins and tigecycline, which are rarely used, to treat pan-resistant bacteria infections.