ABSTRACT
Objective To analyze the clinical features of pandrug-resistant Acinetobacter baumannii (PDR-Ab) in a hospital and compare the efficacy of different antibiotic treatments on patients with pneumonia caused by PDR-Ab.Methods Data were ret- rospectively collected from all isolated PDR-Ab strains in our hospital from February 2004 to March 2005.The clinical features and outcomes were reviewed.Results A total of 77 strains of PDR-Ab were collected, 45 of which were pathogens causing clini- cal infections (35 strains from lower respiratory tract, 6 from bloodstream, 3 from drainage fluid, and 1 from wounds).Lower respiratory tract was the most common source of PDR-Ab.More than 90% of the isolated PDR-Ab strains produced OXA-23 type?-lactamase.Cefoperazone-sulbactam plus minocyeline showed good efficacy for patients with PDR-Ab pneumonia.The total clinical cure rate was 68.4%.Bacterial eradication rate was 42.1%.The factors influencing bacterial clearance were pro- longed mechanical ventilation prior to positive culture (17.5 d vs 5.5 d).mixed infection (100% vs 12.5%) and lower GCS score (9.1?0.7 vs 13.2?2.1).Concomitant septic shock (OR=13.8) and APACHEⅡscore (OR=2.1) were independent factors of clinical outcome.Conclusions Nosocomial infections caused by PDR-Ab are not untreatable.Our analysis suggests that cefoperazone-sulbactam plus minocycline may be an effective treatment for lower respiratory tract infections caused by PDR-Ab in our hospital.