Acinetobacter – MD Nexus

Epidemiology

Outbreaks of Acinetobacter in ICU’s are usually due to multi-drug resistant organisms
Resistance can rapidly develop to tetracyclines, fluoroquinolones, aminoglycosides, and beta-lactams
Risk Factor for Development of Acinetobacter VAP: prior antibiotic use

Acinetobacter baumanii
Acinetobacter calcoaceticus: isolation from the lung of mechanically ventilated patient with VAP portends a worse prognosis

Pneumonia (see Pneumonia, [[Pneumonia]])
Ventilator-Associated Pneumonia (see Ventilator-Associated Pneumonia, [[Ventilator-Associated Pneumonia]])

Colistin (see Polymyxins): approximately 98% of Acinetobacter strains are susceptible to Colistin
Rifampin (see Rifampin): monotherapy is not recommended, as resistance develops quickly
- Rifampin is only effective when given in combination with Colistin
Prolonged Carriage of Organism: a substantial proportion of patients infected with Acinetobacter remain carriers of the organism for a prolonged period
- Long-term contact isolation is recommended

Naas T et al. VEB-1 extended-spectrum beta-lactamase-producing Acinetobacter baumannii, France. Emerg Infect Dis 2006;12:1214
Marchaim D et al. Surveillance cultures and duration of carriage of multidrug- resistant Acinetobacter baumannii. J Clin Microbiol 2007;45:1551
Bassetti M et al. Colistin and rifampicin in the treatment of multidrug-resistant Acinetobacter baumannii infections. J Antimicrob Chemother 2008;61:417.
Munoz-Price LS, Weinstein RA. Acinetobacter infection. New Engl J Med 2008;358(12):1271-1281
Enoch DA, et al. Investigation and management of an outbreak of multidrug-carbapenem-resistant Acinetobacter baumannii in Cambridge, UK. J Hosp Infect 2008;70(2):109-18.
Monterrubio-Villar J, et al. Outbreak of multi-resistant Acinetobacter baumannii in a polyvalent intensive care unit: clinical, epidemiological analysis and PFGE-printing evolution. Eur J Clin Microbiol Infect Dis 2009;28(10):1281-4