多药耐药鲍氏不动杆菌医院感染最新研究进展

Latest progress of study on nosocomial infection caused by multidrug-resistant Acinetobacter baumannii

不动杆菌属中致病性最强的鲍氏不动杆菌,由于其具有极强的环境适应能力和快速获得并传播耐药性的能力,因而极易造成医院内的播散流行;鲍氏不动杆菌引起的医院感染包括呼吸机相关性肺炎、尿路感染、败血症、创口感染及中枢神经系统感染等,严重者可危及生命;近年来,多药耐药鲍氏不动杆菌(MDRAB)的分离率逐渐增加,给临床抗感染治疗和医院感染的控制带来极大挑战,尽管临床上不断推出高效、广谱的抗菌药物,使用先进的消毒洁净技术等防治感染,但MDRAB引起的医院感染问题仍日益突出;该研究综述了MDRAB引起的医院感染的现状、常见耐药机制、危险因素、治疗和预防策略,以期为临床和医院感染控制提供参考。

Acinetobacter baumannii has the strongest pathogenicity among the species of Acinetobacterand tends to be prevalent in hospitals due to its strong environmental adaptability and fast acquisition and transmission of antibiotic resistance.The nosocomial infections caused by the A.baumannii include the ventilator-associated pneumonia,urinary tract infection,sepsis,wound infection,and central nervous system infection;the severe infections may threat to the life.The isolation rate of multidrug-resistant Acinetobacter baumannii（MDRAB）has been gradually increasing in recent years,which brings a great challenge to clinical anti-infection therapy and control of nosocomial infection.Although highly effective,broad-spectrum antibiotics have been developed for clinical treatment and advanced disinfection and cleaning techniques have been applied for prevention of infections,the problem of nosocomial infections induced by MDRAB remains prominent.The review focuses on the prevalence of nosocomial infections caused by MDRAB,common drug resistance mechanisms,risk factors,and treatment and prevention strategies so as to provide guidance for control of the nosocomial infections.