Multi-Drug Resistant Acinetobacter Overview
Acinetobacter spp, opportunistic strains of bacteria, are widely distributed in nature. Generally considered nonpathogenic to healthy individuals, several species persist in hospital environments and cause severe, life-threatening infections in immune-compromised patients.
The spectrum of antibiotic resistances of these organisms, together with their survival capabilities, make them a threat to hospitals, as documented by recurring outbreaks both in highly developed countries and elsewhere.
Acinetobacter species are innately resistant to many classes of antibiotics, including penicillin, chloramphenicol, and often aminoglycosides. A dramatic increase in antibiotic resistance in Acinetobacter strains has been reported by the Centers for Disease Control, and the carbapenems are recognised as the gold-standard and/or treatment of last resort.
Multi-Drug Resistant Acinetobacter Signs And Symptoms
Acinetobacter baumannii can cause:
- infections in the blood
- urinary tract infections (UTIs)
- lung infections (e.g., pneumonia)
- infections in wounds
In some cases, people can carry the bacteria without being infected, known as colonization.
Multi-Drug Resistant Acinetobacter Risk Factors
In the United States, patients in healthcare settings are at highest risk, especially those who:
- Are on breathing machines (ventilators).
- Have devices such as catheters.
- Have open wounds from surgery.
- Are in intensive care units.
- Have prolonged hospital stays.
People who have weakened immune systems, chronic lung disease or diabetes may be more susceptible.
In November 2004, the CDC reported an increasing number of A. baumannii bloodstream infections in patients at military medical facilities in which servicemembers injured in the Iraq/Kuwait region during Operation Iraqi Freedom (OIF) and in Afghanistan during Operation Enduring Freedom (OEF) were treated. Most of these were multidrug-resistant.
Acinetobacter spp are frequently isolated in intensive care units, where both sporadic cases as well as epidemic and endemic occurrences are common. A. baumannii is a frequent cause of nosocomial pneumonia, especially of late-onset ventilator associated pneumonia, and can cause various other infections, including skin and wound infections, bacteremia, and meningitis.
Because A. baumannii can survive on dry surfaces for up to 20 days, they pose a high risk of spread and contamination in hospitals, potentially putting immune-compromised and other patients at risk for drug-resistant infections that are often fatal and generally expensive to treat.
Furthermore, although originating in isolated conflict zones, the incidence of A. baumannii infections is on the increase, according to a 2012 study, particularly in the UK and the US, as the coalition troops exposed to the bacterium in field hospitals return home to convalesce, making it a formidable emerging pathogen. Once A. baumannii is isolated in a hospital environment, this poses a significant risk, particularly in ICU wards where patients are chronically ill. As most of these patients are immunocompromised and spend a prolonged period in hospital, they represent a high risk group for A. baumannii infection.
Multi-Drug Resistant Acinetobacter Treatment
To determine if someone has an Acinetobacter infection, healthcare providers will send a specimen to the laboratory for antimicrobial susceptibility testing. CDC provides data that can be used for setting breakpoints for interpretation of antimicrobial susceptibility testing.
- Antibiotics — Acinetobacter infections are generally treated with antibiotics. To identify the best antibiotic to treat a specific infection, healthcare providers will send a specimen to the laboratory and test the bacteria against a set of antibiotics to determine which are active against the germ. The provider will select an antibiotic based on the test results and other factors, like potential side effects or interactions with other drugs.
- Antimicrobial resistance — Unfortunately, many Acinetobacter germs are resistant to multiple antibiotics, which makes them difficult to treat.
Multi-Drug Resistant Acinetobacter Prevention
Tips for Patients and caregivers
- Keep hands clean by regularly washing with soap and water or using alcohol-based hand sanitizer, including before and after caring for wounds or touching a medical device.
- Remind people (including healthcare providers) to clean hands before touching patient or handling medical devices.
- Allow healthcare staff to clean room daily when in a healthcare setting.
Other Resources and Support
https://www.cdc.gov/acinetobacter/about/