아시네토박터 바우마니 각막염의 임상적 특징
Clinical Features of Acinetobacter Baumannii Keratitis
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목적: 아시네토박터 균종은 다형성을 가진 호기성 그람 음성균으로 자연 환경에 흔히 존재하는 균이다. 최근 아시네토박터 바우마니각막염이 보고되고 있으며 다양한 임상적 특징을 보여 이를 알아보고 치료법에 대하여 고찰해 보고자 하였다. 증례요약: 감염결정각막병증 형태로 나타난 환자 2예, 진균과 복합 감염된 환자 2예, 주변부 각막 궤양의 형태로 나타난 환자 1예가있었다. 진균과 동시 감염된 환자 중 치료적 각막 이식술을 시행한 환자가 1예 있었다. 결론: 아시네토박터 바우마니 각막염은 다양한 임상양상을 보일 수 있다. 생체막을 형성하여 치료에 저항성을 나타낼 수 있고 진균과복합 감염을 보일 수 있으며 일반적인 세균성 각막염이 각막 중심부에 흔히 발생하는 것에 반하여 주변부 각막 궤양의 형태로 나타날수도 있다. 아시네토박터 균종은 다재내성 균으로 흔히 알려졌으나 본원의 5예에서 내성 균주가 발견되지는 않았다. 위와 같은 다양한특성으로 인해 각막염으로 내원한 환자에서 아시네토박터 바우마니의 감염을 항상 염두에 두어야 하겠다.
Abstract
Purpose: Acinetobacter species are common aerobic gram-negative bacterium that contain polymorphisms. Acinetobacter baumanniikeratitis has recently received attention, and has various clinical features. Therefore, it is crucial to determine the appropriatemedical treatment for Acinetobacter baumannii keratitis. Case summary: There were two infectious crystalline keratitis patients, two other patients that were co-infected with fungus, andthe last patient who had the peripheral corneal ulcer type of keratitis. Conclusions: Acinetobacter baumannii keratitis demonstrates multiple clinical features. It forms a biofilm that can bring possibleresistance to therapy, and it can also co-infect with fungus. In contrast to general bacterial keratitis which occurs in the form of acentral corneal ulcer, we found Acinetobacter baumannii to take on the form of a peripheral corneal ulcer in our experiments onthe five keratitis patients. Although Acinetobacter species were originally found to be multidrug-resistant, such resistance wasnot found in our experiments. However, due to the various problems associated with Acinetobacter baumannii, it is always criticalfor medical staff to take infection of Acinetobacter baumannii into consideration in keratitis patients.
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