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OBJECTIF: Revoir et évaluer les informations sur le traitement des infections à Acinetobacter multirésistants.
SOURCE DES DONNÉES: Une revue de la littérature à l'aide de MEDLINE (1966–septembre 2003) d'articles de langue anglaise, ainsi que la revue de la bibliographie secondaire pertinente.
SÉLECTION DES ÉTUDES ET EXTRACTION DES DONNÉES: Tous les articles repérés sont évalués selon des critères cliniques. Le but de cet article est de réviser les données épidémiologiques, microbiologiques, et les études cliniques reliées aux infections à Acinetobacter spp.
SYNTHÈSES DES DONNÉES: Acinetobacter baumannii est un pathogène nosocomial en émergence au niveau mondial et cause une multitude d'infection dont des pneumonies, des bactériémies, des méningites, des infections des voies urinaires, des infections de la peau, et des tissus mous et est associée à un haut taux de mortalité. Des souches résistantes à presque tous les antibiotiques disponibles commercialement ont été isolées, limitant les options thérapeutiques. Le développement de nouveaux agents ou l'utilisation de molécules anciennes (polymixines, ampicilline/sulbactam) sont nécessaires lors de la recherche du traitement optimal des souches multirésistantes.
CONCLUSIONS: Il n'y a pas de réponse simple pour le traitement des infections à Acinetobacter spp. L'éradication nécessite des bonnes pratiques de contrôle des infections et une utilisation prudente des antibiotiques. Les thérapies alternatives (colistine, ampicilline/sulbactam, tétracycline) nécessitent encore des études prospectives, randomisée à double-insue.
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