社区获得性乌尔新不动杆菌肺部感染1例并文献复习

Community-acquired pneumonia caused by Acinetobacter ursingii: one case report and literature review

目的了解乌尔新不动杆菌感染的临床特征。方法报道1例乌尔新不动杆菌引起的社区获得性肺部感染,结合国内外与乌尔新不动杆菌感染相关的文献进行分析。结果感染者无任何基础疾病,在其痰液和肺泡灌洗液中培养出乌尔新不动杆菌,该菌在短时间内产生对含β内酰胺酶抑制剂抗生素的耐药性。查阅文献共检索到乌尔新不动杆菌感染22例,结合本例作一总结。结论乌尔新不动杆菌感染者多为医院获得性感染,尤其是接受过侵袭性操作、并发严重疾病、应用广谱抗生素和长时间住院治疗的患者。该菌耐药性较为突出,亦有对碳青霉烯类抗菌药物耐药的报道。

Objective To review the clinical features of Acinetobacter ursingii infections.Methods One case of A.ursingii infection was described in details.The relevant cases published in literature were reviewed.Results One case of communityacquired pneumonia caused by A.ursingii was reported in a patient without any underlying disease.A.ursingii was isolated from his sputum and bronchoalveolar lavage fluid.The isolate became resistant to piperacillin-tazobactam after treatment for a few days.A total of 23 cases(including this one)of A.ursingii infection were reported so far worldwide.Conclusions Major risk factors for nosocomial infections,such as serious underlying diseases,intravascular or intravesical catheterization,treatment with broad-spectrum antibiotics,and prolonged hospital stay,were identified in nearly all patients.A.ursingii may be highly resistant to antibiotic,including resistance to carbapenems.