鲍曼不动杆菌的研究进展

Research progress of Acinetobacter Baumannii

不动杆菌属(Acinetobacter)是1954年由Brisou等人提出菌属概念,1968年Baumann等人确认Acinetobacter的表型特征,其最重要的代表就是鲍曼不动杆菌(Acinetobacter Baumanii)。在过去的30年中,由于其具有的显著的获得性耐药能力,使其成为威胁当前抗生素的病原微生物之一,也是所有国家的医院内感染的主要原因之一。目前出现对所有已知抗生素有抗性的鲍曼不动杆菌菌株,已引起世界卫生组织的高度重视。该菌通常针对最脆弱的住院患者和严重呼吸道疾病患者。根据回顾性的研究报告,医院获得性肺炎仍是由该病原微生物引起的最常见的感染。最近,涉及中枢神经系统、皮肤和软组织和骨的感染已经出现,这将对医疗机构造成严重威胁。目前有研究认为广谱抗菌药物和免疫抑制剂的广泛应用,可诱导细菌基因发生改变形成多重耐药鲍曼不动杆菌(multidrug-resistant Acinetobacter Baumannii,MDRAB),其耐药机制为产OXA-23型碳青霉烯酶、抗生素作用靶位变异、细菌生物被膜的形成和外排泵基因的影响。面对MDRAB院内快速传播的严峻医疗形势,加强医院感控管理、联合应用抗菌药物和细菌疫苗的研究,为临床上防治MDRAB的产生提供治疗方向。作者主要对近年来鲍曼不动杆菌的耐药机制和应对措施研究作一综述。

Acinetobacter was put forward by Brisou in 1954. Bauman confirmed the phenotypic characteristics of Acinetobacter in 1968. Acinetobacter baumannii is the most important representative of Acinetobacter . In the past 30 years, because of its remarkable acquired resistance, it has become one of the pathogenic microorganisms threatening current antibiotics and one of the main causes of nosocomial infections in all countries. It has been reported that Acinetobacter Baumannii strains resistant to all known antibiotics have attracted great attention of WHO. The bacteria are usually targeted at the most vulnerable inpatients and those with severe respiratory diseases. According to the review report, hospital acquired pneumonia is still the most common infection caused by the pathogenic microorganism. However, in recent years, infections involving the central nervous system, skin and soft tissue and bone have emerged, which will pose a serious threat to medical institutions. At present, it is believed that the wide application of broad-spectrum antibiotics and immunosuppressants can induce gene alteration of bacteria to form multidrug-resistant Acinetobacter Baumannii (MDRAB). Its drug resistance mechanism is OXA-23 carbapenemase production, target mutation of antibiotic action and bacterial biofilm. Formation and efflux pump genes. Facing the severe medical situation of rapid spread of MDRAB in hospital, strengthening the management of nosocomial infection and the study of combined application of antibiotics and bacterial vaccines provide the treatment direction for preventing and curing the occurrence of MDRAB in clinic. In this paper, we reviewed the mechanism of resistance to Acinetobacter Baumannii and the countermeasures in recent years.