鲍曼不动杆菌

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telcontar
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76556
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鲍曼不动杆菌
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2011-03-31 23:52:33
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鲍曼不动杆菌
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鲍曼不动杆菌 The Johns Hopkins ABX
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  1. 鲍曼不动杆菌是
    Aerobic gram-neg coccobacilli or rods, often mistaken for Neisseria or Moraxella on Gram stain.
  2. 鲍曼不动杆菌常见于
    Common in environment (water, soil) and hospital (catheters, lotions, ventilation equipment).
  3. 鲍曼不动杆菌生长于
    Grows on standard agar media.
  4. 其它不动杆菌包括:
    A. baumannii is the major species of Acinetobacter. Others occasional human pathogens include A. calcoaceticus, A. lwoffi, A. junii, A. johnsonii and A. baylyi.
  5. 鲍曼不动杆菌的易感人群
    A. baumannii is low grade pathogen affecting compromised hosts (immunosuppression, post-surgical, ventilator-associated pneumonia, burn wounds, ICU pts, device-associated infections and malnutrition).
  6. 鲍曼不动杆菌的流行病学
    Emerging as important global, pan-resistant GNB nosocomial pathogen.
  7. 鲍曼不动杆菌阳性结果意义
    Clearly pathogenic when recovered from blood and normally sterile body sites.
  8. 鲍曼不动杆菌高危因素
    Risks: hospitalization, ICU, surgery, antibiotic exposure and catheters.
  9. 常见鲍曼不动杆菌致病设备
    May cause nosocomial epidemics from contaminated common sources, e.g., ventilation equipment, catheters, etc.
  10. 鲍曼不动杆菌确诊标准
    Diagnosis by standard aerobic bacterial culture.
  11. 鲍曼不动杆菌的病原结果的意义
    Lab isolations often meaningless (representing colonization) unless from
  12. normally sterile site
    • found as a dominant pathogen and moderate or heavy growth from potentially contaminated sites
    • outbreak and/or
    • good clinical correlation.
  13. 常见的鲍曼不动杆菌感染
    • Usually a cause of nosocomial infections.
    • Pneumonia: nosocomial, especially ventilator-associated.
    • Septicemia: often catheter-associated, or consequence of HAP or VAP.
    • Wounds: burns, war wounds acquired in Iraq, natural disasters--hurricanes/earthquakes.
    • Rare: meningitis (post-neurosurgical), liver abscess, endocarditis, urinary tract infections, brain abscess.
    • Community-acquired: reports from Iraqi war theater, one major report from New Zealand.
  14. 鲍曼不动杆菌的常用治疗药
    Antibiotic selection guided by in vitro sensitivity tests--most active: imipenem, ampicillin/sulbactam, colistin, tigecycline and amikacin.
  15. 鲍曼不动杆菌的碳青霉烯治疗
    • Imipenem:0.5-1gm IV q6h,
    • meropenem:0.5-1gm IV q 8h,
    • doripenem:500 mg IV q 8h.
  16. 鲍曼不动杆菌阿莫西林/舒巴坦的治疗方案
    Ampicillin/sulbactam: 3 gm ampicillin/1.5 gm sulbactam IV q 6h (sulbactam is the active component).
  17. 用于鲍曼不动杆菌的其它抗菌药
    Other agents with variable activities: aminoglycosides, cephalosporins, minocycline, rifampin.

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