不動桿菌：感染管制的一大威脅

Acinetobacter Infection: A Threat to Infection Control

近年來，不動桿菌數的細菌在公衛、科學與醫學領域受到廣泛的重視。不動桿菌多半屬於人體的移生菌叢（colonization），主要存在皮膚與黏膜表面。而這些微生物不僅與偶發的社區型感染有關，還經常造成院內群突發事件。其中，鮑氏不動桿菌（Acinetobacter baumannii）是最常造成人類感染症的不動桿菌，它能對許多抗生素在短時間內產生抗藥性，再加上它容易生存於醫院的各種環境，導致了許多健康照護單位群突發事件（outbreak）。此外，鮑氏不動桿菌的感染有時與天然與人為災害產生關聯（例如：地震、洪水氾濫、海嘯、恐怖攻擊事件及軍事行動等），當醫院照護病人的能力超出負荷，而標準感管流程無法有效執行時，便容易發生群突發事件。欲防治與控制不動桿菌數造成的群突發事件，必須加強標準感染管制流程，尤其是注重病人周邊區域的清潔。本文主要針對現今不動桿菌尤其是鮑氏不動桿菌，其流行病學與臨床感染做了進一步的討論。

In recent years, members of the genus Acinetobacter have received significant attention from public, scientific, and medical communities. Most species of Acinetobacter are normal flora that colonize the skin and mucous membranes of humans. Although these organisms are often associated with nosocomial infections, they have also been implicated in community-acquired infections. Human Acinetobacter infections are most frequently caused by Acinetobacter baumannii, which rapidly develops resistance to multiple antibiotics. This characteristic is compounded by its unique ability to survive in a diverse range of environments, leading to outbreaks in healthcare institutions. A. baumannii infection is also associated with natural and manmade disasters such as earthquakes, floods, tsunami, terrorist attacks, and military campaigns; infections occur when hospitals operate beyond their capacities and neglect standard hygiene procedures. Prevention and control of outbreaks caused by Acinetobacter focus on reinforcing standard infection control procedures and thoroughly cleaning patient areas. In this review, the currently epidemiology and clinical aspects of infections caused by species of Acinetobacter, particularly A. baumannii, are discussed in depth.