Strategy of prevention and treatment of multidrug-resistant Acinetobacter baumannii

The rate of multidrug-resistant Acinetobacter baumannii(MDR-AB) has increased greatly since extensive using of antibiotics.Strains of carbapenem-resistant Acinetobacter baumannii reach over 48 percent,even pandrug-resistant Acinetobacter baumannii has emerged.The mechanisms of drug-resistance are production of antimicrobial hydrolases,lack of outer membrane protein,decreased membrane permeability,and changes of targets or active efflux pump.Therapeutic options are limited for MDR-AB,especially if isolates are resistant to carbapenem class of antimicrobial agents.Sulbactan,colistin,tegecycline,and carbapenem can be chosen according to the drug-susceptibility test.And antimicrobial combination is suggested for severe cases.It should be emphasized that the best solution to drug-resistance is prevention of transmission of MDR-AB.Hand hygiene,standardized preventive measures,appropriate isolation precautions,surveillance of drug-resistance are the best measures of preventing MDR-AB transmission.