2012-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/646230摘要：鮑氏不動桿菌 (A. baumannii)近來受到相當多的重視，因此菌常引起院內突發事件或廣傳於醫院中；因此菌亦為院內感染的一大威脅，因其可在環境中存活甚久，且本身天生常有多重抗藥性。鮑氏不動桿菌引起的院內感染這幾年也是逐漸的在增加，尤其是加護病房病患或是免疫不全的病患。鮑氏不動桿菌感染會有高致死率也會延長病患的住院時間。Acinetobacter 屬(genus Acinetobacter)之下，可用分子生物學的方法分出多達33 種基因分類(genospecies)；其中A. baumannii (genospecies 2), genospecies 3, 13TU 可引起臨床人類疾病及院內傳播；但臨床的生化檢查，並無法對這三種genospecies 做很好的分辨，僅能將A. calcoaceticus (genospecies 1), A. baumannii, genospecies 3, 13TU 歸類為A.calcoaceticus-A. baumannii complex (ACB complex)。雖然說genospecies 2 被認為和人類疾病較為相關，但不同基因型間對臨床預後影響的研究還是相當有限。事實上把ACBcomplex 當成擁有相同的臨床預後影響是不適宜的，因為不同的ACB complex 間有不同的生物學上的特性。比如genospecies 1 被認為是環菌鮮少造成人類的疾病，而且不同基因型中是實上也已經證實有不同的皮膚移生能力，不同的抗藥性及抗藥性機轉。因此本研究首先希望先建立適當的鮑氏不動桿菌敗血症模型，接著利用動物模型來比較不同基因型間的不同致病毒性。除了監測實驗動物的死亡，及生理變化外，我們同時也比較不同基因型間所引起的活性氧物種(reactive oxygen species;ROS)，及細胞激素。本實驗的目的在於，若能了解不同基因型間的不同致病毒性，那麼以後便能針對高致病毒性的菌株感染給予更即時且有效的治療來改善病患的預後，而對於那麼低致病毒性的菌株感染就能避免不需要的後線抗生素使用，也減少可能產生抗生素抗藥性的機會。<br> Abstract: Acinetobacter baumannii has been emerging in causing outbreaks and widely spreadingin hospitals. It poses a difficult challenge for infection control because it can survive for longperiods in environments and their natural inheritance of multiple drug-resistances.Healthcare-associated infections related to A. baumannii have increased recently, especially ofpatients at intensive care unit (ICU) and in immunocompromized condition. Patients with A.baumannii infections also had high mortality and prolonged length of hospital stay.Acinetobacter genospecies 1 (A. calcoaceticus), genospecies 2 (A. baumannii),genospecies 3, and genospecies 13TU are phenotypically similar and are referred to as the A.calcoaceticus-A. baumannii complex (ACB complex). Genospecies 2 is primarily associatedwith human diseases, however the impact of different genospecies on clinical characteristicsand outcomes among ACB complex remains rarely studied. It is unreasonable to pool theACB complex as a group when identifying the characters of infections, because differentgenospecies among ACB complex may have different biological and pathologicalcharacteristics. For example, genospecies 1 is considered as environmental pathogen ratherthan causing healthcare-associated infection. Different genospecies of ACB complex havedifferent tendency of human skin colonization, different antimicrobial susceptibility, anddifferent resistant mechanism to antimicrobial agents.Thus, we first aim to establish animal model of A. baumannii sepsis. We will use theestablished model to compare the virulence of difference A. baumannii complex genospecies.The virulence is evaluated by mortality, and the physiological parameters of animal models,and also by measures of induced reactive oxygen species, and cytokines. Knowing thevirulence differences of different genospecies not only may facilitate prompt appropriatetreatment of high virulence strain and then improve clinical outcome, but also may avoidunnecessary treatment of low virulence strains and further prevent emergence of antibioticsresistance.鮑氏不動桿菌基因分型動物模型Acinetobacter baumanniigenospeciesanimal model