Hastanelerde güncel bir sorun: çoklu ilaca direncli Acinetobacter baumannii enfeksiyonlarının tedavisi

Year 2019, Volume: 1 Issue: 2, 37 - 41, 18.04.2019

Metin Özsoy Meliha Sönmezer Sami Kınıklı

https://doi.org/10.38053/agtd.526530

Cited By: 1

Abstract

Acinetobacter türleri doğada
yaygın olarak bulunan aerobik, Gram negatif, hareketsiz, fermantasyon yapmayan
bakterilerdir. Bu türler içerisinde Acinetobacter baumannii (A.
baumannii) sağlık bakımıyla ilişkili enfeksiyonlar içerisinde önemli
bir yer tutmaktadır. Hastanelerde özellikle  yoğun bakım üniteleri
olmak üzere, hastanelerin çeşitli birimlerinde ciddi hastane enfeksiyonlarından
sorumlu önemli fırsatçı patojenlerin başında gelmektedir. Yaygın olarak travma,
mekanik ventilasyon ve  girişimsel işlemlere bağlı olarak gelişen pnömoni,
endokardit, menenjit, deri ve yara enfeksiyonları, peritonit ve üriner
sistem  enfeksiyonlarına neden olmaktadır. Son 10 yılda  A.
baumannii suşlarında gittikçe yaygınlaşan çoklu ilaca direnci (3 veya
daha fazla sayıda farklı antibiyotik grubuna direnç görülmesi) nozokomiyal
gram negatif patojenler içerisinde kontrol ve tedavisi en güç olanlardan biri
haline gelmiştir. A. baumannii ile enfekte hastalar sıklıkla
immün yetmezliklidirler ya da hastalık durumları ağır olup, mortalite oranları
oldukça yüksektir. A. baumannii salgınlarının pek çoğu hasta
yatakları, klimalar,  mekanik ventilasyon ekipmanları,  hastane
personelinin elleri veya çevresel kontaminasyonlara bağlı olarak ortaya
çıkmaktadır. A. baumannii infeksiyonlarının artması enfeksiyon
kontrol uygulamalarındaki hatalara bağlıdır. Hastaların bir kısmının A.
baumannii ile enfekte ya da kolonize olduğu durumlarda; hastalar
arasındaki çapraz geçişler kolonizasyon ve/veya salgın oluşumunu artırmaktadır.
Bu derlemede, ÇİD-A. baumanni suşlarının mikrobiyolojisi, tedavisi
ve enfeksiyon kontrol önlemleri tartışılacaktır.

 

Keywords

Acinetobacter baumannii, çoklu ilaca direnç, tedavi, enfeksiyon kontrol önlemleri

A recent problem at hospitals: treatment of multi-drug resistant Acinetobacter baumanii infections

Abstract

Acinetobacter baumannii (A.
baumannii) is one of the most prominent hospital-borne pathogens
encountered worldwide in health institutions, mostly at Intensive Care Units (ICU),
which develops resistance to many antimicrobial classes. A.
baumannii causes pneumonia, urinary tract infections, soft tissue
infections, surgical site infections, catheter infections and bacteremia mostly
in the ICU and inpatients. Infections, which develop with this pathogen are
also often treatment-resistant. Epidemics arising from A.
baumannii, which is resistant to various antimicrobial classes unfold through
cross-infection of such 'reknown' sources as ventilators or the hands of health
workers. The definition of multidrug-resistant (MDR) A. baumannii differs from that in the literature and country but
still the common definition deals with strains, which are resistant to three or
more groups of antibiotics. These groups of antibiotics can be carbapenems,
aminoglycosides and fluoroquinolones. In this review, resistance mechanism and
treatment options in MDR A.baumannii
isolates will be discussed.

Keywords

Acinetobacter baumannii, multi-drug resistant, treatment, infection control measurment

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