With this new column, Elite will compile an index of various infectious diseases, with occasional highlights of emerging conditions.
Acinetobacter Bacteria Infections
General definition and information: Ubiquitous infections caused by a group of bacteria that are known to survive on dry surfaces for lengthy periods and are commonly carried on the skin of healthcare workers. According to the Centers for Disease Control and Prevention (CDC), Acinetobacter infections rarely occur outside of healthcare settings, although the bacteria are commonly found in soil and water.1 Most commonly seen in intensive care units and other healthcare settings that house patients who are very ill, Acinetobacter causes a variety of diseases ranging from pneumonia to serious blood or wound infections. Other types of these infections also include meningitis, necrotizing fasciitis, and urinary tract infections.2 Although there are many types of Acinetobacter infections, Acinetobacter baumannii, an increasingly more common nosocomial condition, accounts for about 80% of reported infections, according to the CDC.
Modes of transmission: Typically impacting only those who are already unhealthy, Acinetobacter can be spread to susceptible people by person-to-person contact or contact with contaminated surfaces.1 According to the CDC, these infections pose little risk to healthy individuals. Those at risk include those with weakened immune systems, chronic lung disease, or diabetes. Risk factors increase when patients are on a ventilator, require a prolonged hospital stay, are living with open chronic wounds, and/or require invasive devices such as urinary catheters.1
Treatment strategies: Because they are often resistant to many commonly prescribed antibiotics Acinetobacter infections should be treated on a case-by-case basis according to the CDC. According to one study, there is relatively limited well-controlled scientific data to help clinicians select optimal empirical and subsequent targeted therapy for a variety of these infections.3 Beta-lactam antibiotics are the preferred antibacterial choices for susceptible these infections, according to one report.4 Carbapenems have become an increasingly critical therapeutic option for these infections as well; however, carbapenem resistance rates have been rising dramatically in the United States and globally.4 Minocycline may retain antimicrobial activity even against strains resistant to other tetracyclines (including tigecycline), although cross-resistance has been reported.4 In cases of non-bacteremic drug-resistant Acinetobacter pneumonia, the addition of inhaled colistin can be considered and may minimize toxicity while increasing antibiotic delivery to the lung.4
Prevention parameters: Acinetobacter may survive in its environment for several days, according to the CDC, which advises that clinicians pay careful attention to infection control procedures, such as hand hygiene and environmental cleaning to better reduce the risk of transmission.1
References
1. Acinetobacter in healthcare settings. CDC. 2010. Accessed online: www.cdc.gov/hai/organisms/acinetobacter.html
2. Bennington-Castro J. What is acinetobacter baumannii? Everyday Health. 2019. Accessed online: www.everydayhealth.com/acinetobacter/guide
3. Fishbain J, Peleg AY. Treatment of acinetobacter infections. Clinical Infectious Diseases. 2010;51(1):79-84.
4. Acinetobacter medication. Medscape. 2019. Accessed online: https://emedicine.medscape.com/article/236891-medication
5. Gisler S. NIH funds fight against CF-associated antibiotic resistant bacteria. Cystic Fibrosis News Today. 2019. Accessed online: https://cysticfibrosisnewstoday.com/2019/02/21/nih-funds-fight-against-cf-associated-antibiotic-resistant-bacteria/
