广泛耐药鲍曼不动杆菌(Extensively Drug Resistant Acinetobacter baumannii, XDRAB)是指对仅有1~2种可能具有抗菌活性的药物(主要是替加环素和/或多黏菌素)敏感的菌株。它是一种人类机会性致病菌,尤其在长期住院的患者中更为常见。XDRAB的治疗一直是一个难题。本文报告了一例医院获得性XDRAB感染导致的重症肺炎患者的治疗过程。我们先后使用了哌拉西林钠他唑巴坦钠、美罗培南、万古霉素及多粘菌素等多种抗生素,但效果不佳。最终通过联合使用可利霉素治疗,患者病情得到改善并顺利出院。本文通过分析该病例的临床特点及诊治过程,并复习相关文献,旨在提高临床医生对XDRAB的诊治水平,并希望为进一步研究其体内外抗菌作用提供参考。Extensively Drug-Resistant Acinetobacter baumannii (XDRAB) refers to strains that are susceptible to only one or two potentially active antimicrobial agents (primarily tigecycline and/or polymyxins). It is an opportunistic human pathogen, particularly prevalent among long-term hospitalized patients. The treatment of XDRAB has remained a significant challenge. This article reports the treatment process of a patient with severe pneumonia caused by hospital-acquired XDRAB infection. We sequentially administered multiple antibiotics, including piperacillin sodium-tazobactam sodium, meropenem, vancomycin, and polymyxin, but the response was poor. Ultimately, the patient’s condition improved and they were successfully discharged after combination therapy with carrimycin. By analyzing the clinical characteristics, diagnosis, and treatment process of this case and reviewing relevant literature, this study aims to enhance clinicians’ understanding of XDRAB management and provide a reference for further research on its in vitro and in vivo antibacterial effects.
支气管哮喘和慢性阻塞性肺疾病均是慢性气道炎症性疾病,尽管从发病机制到临床表现两者各有不同,但越来越多的研究表明两者在病因、发病机制和临床表现等诸多方面均有许多相似之处。解整合素-金属蛋白酶(a disintegrin and metalloprotease,ADAM)33基因作为首次通过定位克隆技术确定的哮喘易感基因,近几年的研究证实该基因与慢性阻塞性肺疾病的发生发展也有关联。ADAM33基因是否能架起哮喘和慢性阻塞性肺疾病共同发病机制的桥梁,笔者对近年来该基因的研究进展进行综述。
