Nosocomial Pneumonia Caused by Acinetobacter spp.
E. Bergogne-Bénézin, M.L. Joly-Guillou, K.J. Towner in Acinetobacter, 2020
As described in Chapters 4 and 5, Acinetobacter baumannii is now recognised to be the Acinetobacter species associated with the majority of human infections caused by this genus, including nosocomial outbreaks of pulmonary infection (Allen and Hartman, 1990; Bergogne-Bérézin and Joly-Guillou, 1991). While nosocomial infections caused by Acinetobacter spp. remain relatively uncommon, accounting for <1% of the burden of endemic infections in most hospitals (Centers for Disease Control, 1987), a number of outbreaks of nosocomial pulmonary infection have been described in ICUs, and the role played by these organisms in ventilator-associated pneumonia is obviously increasing (Buxton et al., 1978; Castle et al., 1978; Cunha et al., 1980; Stone and Das, 1985; Hartstein et al., 1988; Vandenbroucke-Grauls et al., 1988; Cefai et al., 1990; Bergogne-Bérézin and Joly-Guillou, 1991). Regardless of the bacteriological method used to define the cause of pneumonia precisely, several studies have reported that about 3-5% of nosocomial pneumonias are caused by Acinetobacter (Centers for Disease Control, 1987; Craven et al., 1990). In patients with pneumonia enrolled in the National Nosocomial Infection Study (Schaberg et al., 1991), this organism accounted for 4% of the total number of pulmonary infections, and was ranked in seventh position in the list of pathogens identified most frequently in the survey, while it was not included in this list in 1984, and was in tenth position in 1988 (Table 6.1).
Combination Antimicrobial Therapy for Gram-Negative Infections: What Is the Evidence?
Robert C. Owens, Lautenbach Ebbing in Antimicrobial Resistance, 2007
Acinetobacter baumannii has emerged as a significant nosocomial pathogen in hospitalized patients worldwide. The rising incidence of infections caused by Acinetobacter spp. is of particular concern because of the high rates of multidrug resistance (166). Data from the SCOPE study showed that, over a 7-year period from 1995 to 2002, 25% of nosocomial bacteremias (24,179 total isolates) were caused by Gram-negative bacilli (19). Acinetobacter species accounted for 1.6% of nosocomial bacteremia and were the 10th leading cause of bacteremia. At present, more than 85% of isolates are susceptible to carbapenems, but resistance is increasing due to either IMP-type metalloenzymes or carbapenemases of the OXA type (167,168).
Acinetobacter baumannii
Firza Alexander Gronthoud in Practical Clinical Microbiology and Infectious Diseases, 2020
Acinetobacter baumannii is mainly associated with hospital-acquired pneumonia and bloodstream infections which may be reflected by its high colonization rate of the respiratory tract and intravascular devices in ICU patients. Other clinical presentations are catheter-associated urinary tract infections, burn infections and neurosurgical infections including ventriculitis.
Contribution of NDM and OXA-type carbapenemases to carbapenem resistance in clinical Acinetobacter baumannii from Nigeria
Published in Infectious Diseases, 2020
David O. Ogbolu, Oyebode A. Terry Alli, Adeolu S. Oluremi, Y. Temilola Ogunjimi, D. Iyanu Ojebode, Veronica Dada, Olubunmi O. Alaka, Ebenezer Foster-Nyarko, Mark A. Webber
Acinetobacter baumannii is an opportunistic pathogen in humans, it poses little risk to healthy individuals, but generally causes infections in those with weakened immune systems. Specifically, invasive tools like catheters are factors that predispose to A. baumannii infections such as, meningitis, wound infection, septicaemia, urinary tract infections [1] and nosocomial and ventilator-associated pneumonia, especially in intensive care unit (ICU) patients [2,3]. It is an important cause of multidrug-resistant (MDR) nosocomial infections worldwide [4]; compared to methicillin-resistant Staphylococcus aureus (MRSA) leading to it even been termed the ‘gram-negative MRSA’ [5]. A. baumannii has also been identified as an ESKAPE pathogen (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter species), a group of pathogens with a high rate of antibiotic resistance that are responsible for the majority of nosocomial infections [5].
Inhibitory effect of α-mangostin on Acinetobacter baumannii biofilms – an in vitro study
Published in Biofouling, 2018
Murugesan Sivaranjani, Ramanathan Srinivasan, Chairmandurai Aravindraja, Shunmugiah Karutha Pandian, Arumugam Veera Ravi
Acinetobacter baumannii (AB) has emerged as a troublesome nosocomial pathogen in modern health care systems, and is associated with bacteremia, endocarditis, ventilator-associated pneumonia (VAP), meningitis, and respiratory tract and urinary tract infections in critically ill patients (Zarrilli et al. 2009; Wang et al. 2017). It has been estimated that the mortality rates associated with AB induced VAP and blood stream infections are 40–70% and 28–43%, respectively (Garnacho et al. 2003; Wareham et al. 2008). Moreover, AB strains frequently develop antibiotic resistance against polymyxins, tigecycline, penicillin, cephalosporin and carbapenems, due to the expression of efflux pumps, changes in porin proteins and secretion of β-lactamases (Mah and O’Toole 2001; Peleg et al. 2008). Owing to the high prevalence of multi-drug resistant and extensively drug resistant strains of AB, it has been listed among the top seven pathogens threatening the current antibiotic era and its outbreak frequency has increased worldwide over the past 20 years (Talbot et al. 2006; Manchanda et al. 2010; Pour et al. 2011; Tiwari and Moganty 2014). The most important factor that contributes to the establishment of AB infections is the ability to form biofilm on the surfaces of medical devices as well as host tissues, which has received attention among scientific communities in recent years (Singhai et al. 2012).
What are the considerations for the treatment of multidrug resistant Acinetobacter baumannii infections?
Published in Expert Opinion on Pharmacotherapy, 2022
Kittiya Jantarathaneewat, Bernard Camins, Anucha Apisarnthanarak
Acinetobacter baumannii (A. baumannii) is a ubiquitous pathogen which can be found in the environment (e.g. soil and food) and hospitals (e.g. hospital surfaces, tap water, and the sink). A. baumannii causes a wide range of hospital-acquired infections and has emerged as a very difficult-to-treat pathogen, particularly in the intensive care unit (ICU) setting. It has been associated with 8–35% mortality [1]. The global incidence of A. baumannii infections is estimated to be 600,000 to 1,400,000 cases per year of which half are carbapenem-resistant [2]. Endemic areas for multidrug resistant (MDR) A. baumannii include both South and Southeast Asia, as well as Southern and Eastern European countries. MDR-A. baumannii infections are associated with 2.6 times higher mortality rate compared to infections caused by susceptible strains [3]. Furthermore, A. baumannii infections are often polymicrobial and differentiating infection from colonization can be difficult [4]. Pan drug-resistant A. baumannii (PDRAB) is increasingly reported worldwide [5] and, is associated with significant excess mortality [6] with few treatment options [7]. By definition PDRAB is resistant to all available antibiotics therefore synergistic combinations are often the only treatment options [8]. Data regarding synergistic combinations against PDRAB are mainly based on in vitro experiments, few animal models and small case series or reports [8]. Furthermore, the methodology for identifying synergistic combinations against PDRAB is often problematic [9].
Related Knowledge Centers
- Acinetobacter
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- Pilus
- Coccobacillus
- Gram-Negative Bacteria
- Hospital-Acquired Infection
- Moraxellaceae