上海交通大学学报（医学版）

›› 2012, Vol. 32 ›› Issue (6): 815-.doi: 10.3969/j.issn.1674-8115.2012.06.027

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烧伤患者耐药鲍曼不动杆菌感染的抗菌药物选择

黄晓琴, 郇京宁   

  1. 上海交通大学 医学院附属瑞金医院烧伤整形科, 上海 200025
  • 出版日期:2012-06-28 发布日期:2012-07-02
  • 通讯作者: 郇京宁, 电子信箱: jnhuan@yahoo.com。
  • 作者简介:黄晓琴（1978—）, 女, 硕士生；电子信箱: xqhuang_1@hotmail.com。

Choice of antimicrobial agents for multidrug-resistant Acinetobacter baumannii infection in burns

HUANG Xiao-qin, HUAN Jing-ning   

  1. Department of Burn &|Plastic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2012-06-28 Published:2012-07-02

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摘要：

耐药性鲍曼不动杆菌是严重烧伤感染的重要致病菌之一，其耐药机制与细菌产生多种β-内酰胺酶、膜药物通透性缺陷、药物外排系统和细菌生物膜形成等有关。针对烧伤创面鲍曼不动杆菌感染，磺胺嘧啶银霜、磺胺米隆溶液和银离子敷料是良好的局部外用药物。在耐药鲍曼不动杆菌脓毒症的治疗方面，可选择多黏菌素、舒巴坦、米诺环素和替加环素。但是，尤为重要的手段是联合应用抗生素。此外，该文还讨论了某些新型药物的抗耐药鲍曼不动杆菌的作用。

关键词: 鲍曼不动杆菌, 烧伤, 感染, 耐药性, 抗生素

Abstract:

Multidrug-resistant Acinetobacter baumannii infection represents a growing problem in severe burns. The antimicrobial resistance mechanisms of Acinetobacter baumannii include an increasing arsenal of β-lactamases, altered expression of outer membrane protein, efflux pumps and biofilm formation. For Acinetobacter baumannii wound infection, silver sulfadiazine, sulfamylon and silver dressing are effective topical agents. The effective treatment with antibiotics in Acinetobacter baumannii sepsis involves polymyxins, sulbactam, minocycline and tigecycline, and the combination use of antibiotics is strongly recommended. Besides, some novel therapeutic agents for multidrug-resistant Acinetobacter baumannii are introduced in this paper.

Key words: Acinetobacter baumannii, burn, infection, drug-resistance, antibiotics