176.4 📌 章末速蚘

  • Acinetobacter baumannii — gram - coccobacillus, oxidase NEG, ICU/burn/vent/戰堎
  • WHO critical priority, MDR > Pseudomonas
  • 䞻芁 syndromes: VAP/HAP, bacteremia, wound, meningitis (post-NSx)
  • OXA carbapenemases: OXA-23, 24/40, 58 — Acinetobacter-specific
  • Treatment 2023:
    • Sulbactam-durlobactam (Xacduro) + imipenem — first-line CRAB
    • Cefiderocol — alternative
    • High-dose amp-sulbactam, polymyxin (last)
    • Combination therapy common
  • Dry surface 1 month+ → environmental cleaning + isolation
  • 鑑別 Pseudomonas: oxidase NEG, coccobacillus, no pigment
  • Combat / 戰堎 — Ukraine 2022+ outbreaks