Clinical Characteristics of Tertiary Hospital Patients from Whom Acinetobacter calcoaceticus-Acinetobacter baumannii Complex Strains were Isolated
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概要
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Objective Acinetobacter baumannii is a worldwide nosocomial pathogen that has become increasingly common over the past few decades, and strains of multidrug-resistant A. baumannii have been increasing. The aim of this study was to assess the clinical characteristics of A. calcoaceticus-A. baumannii complex (Acb complex) strains and to determine the risk factors of this infection. Methods The medical records of 121 patients at Nagasaki University Hospital from whom Acb complex had been isolated between January 2007 and December 2009 were retrospectively reviewed. Patient backgrounds, sensitivity to antibiotics, risk factors for infection, and prognosis were evaluated. Results Lower respiratory isolates accounted for 73% (147 strains) of all 201 isolates. Most of the isolates were sensitive to carbapenems. Of the 121 patients (74 males and 47 females; mean age: 62.1 years), 48 (39.7%) had malignancy and 75 (62.0%) were treated with antibiotics prior to isolation. Thirty-seven of the patients in this study (30.6%) were infected by Acb complex and the most frequent clinical manifestation was pneumonia (18 cases; 48.6%). Approximately 60% of infected patients were treated with β-lactam agent in combination with β-lactamase inhibitors or carbapenems. The mortality rate of infected patients was significantly higher than that of colonized patients (infected: 24.3%, colonized: 6.0%, p<0.05). Risk factors for Acb complex infection include being over 60 years of age, chronic liver disease, and the use of first-generation cephalosporins prior to isolation. Conclusion Acb complex was relatively sensitive to antibiotics. The appropriate usage of antibiotics should be continued for the prevention of drug resistance in Acb complex.
著者
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Kamihira Shimeru
Department Of Laboratory Medicine Nagasaki University Graduate School Of Biomedical Sciences
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Yamada Koichi
Department Of Agricultural Chemistry The University Of Tokyo
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MORINAGA Yoshitomo
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagas
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Yamamoto Yoshihiro
The Second Department Of Internal Medicine Kansai Medical University
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Kohno Shigeru
The Scientific Assembly For Infection And Tuberculosis Of The Japanese Respiratory Society
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Araki Nobuko
Department Of Laboratory Medicine Nagasaki University Graduate School Of Biomedical Sciences
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Akamatsu Norihiko
Department Of Laboratory Medicine Nagasaki University Graduate School Of Biomedical Sciences
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Yanagihara Katsunori
Department Of Clinical Laboratory Nagasaki University Hospital
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Izumikawa Koichi
The Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Kakeya Hiroshi
The Second Department of Internal Medicine, Nagasaki University School of Medicine
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Matsuda Junichi
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Matsuda Junichi
Department of Earth and Space Science, Graduate School of Science, Osaka University
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Harada Yosuke
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Araki Nobuko
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Hasegawa Hiroo
The Second Department of Internal Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Kamihira Shimeru
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Yanagihara Katsunori
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Morinaga Yoshitomo
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Morinaga Yoshitomo
Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences
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