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PubMedDate not supplied

The role of Acinetobacter baumannii as a nosocomial pathogen for dogs and cats in an intensive care unit.

Acinetobacter baumannii is a nosocomial pathogen associated with high morbidity and mortality in humans. Whereas infections with strains of Acinetobacter species have been reported in various situations, the importance of A baumannii as a nosocomial pathogen in veterinary hospitals has not been studied so far. In this retrospective case series, we describe 17 dogs and 2 cats from which A baumannii had been isolated during a 2 1/2-year period. In 7 dogs, A baumannii induced systemic signs of illness, whereas 12 animals showed signs of local infection. In all animals with systemic infection, and in 2 with localized infection, A baumannii contributed to the death of the animal or contributed to euthanasia; the remaining 8 dogs and both cats recovered. Molecular typing of the isolates with restriction polymorphisms of ribosomal DNA provided evidence of nosocomial spread of this pathogen and for the presence of several strains of A baumannii in the hospital environment.

Acinetobacter↗
PubMed2006

VIM-1 metallo-beta-lactamase in Acinetobacter baumannii.

In 2004 and 2005, 5 metallo-beta-lactamase (MBL)-positive Acinetobacter baumannii isolates were found in 2 Greek hospitals. Isolates were unrelated and carried blaVIM-1 in a class 1 integron; bla(OXA-51-) and bla(OXA-58-like) carbapenemase genes were also detected. VIM-1 MBL in Acinetobacter spp. causes concern, given the increasing resistance of this species.

Acinetobacter Infections↗
PubMed1977

Acinetobacter septicaemia following prolonged intravenous therapy.

A 76-year-old man developed septicaemia during the infusion of stable plasma protein solution (SPPS) which was subsequently shown to be contaminated with Acinetobacter anitratus. Septicaemia persisted for four days despite change of the intravenous cannula and administration of an appropriate antibiotic. Clinical improvement occurred only when the entire intravenous line, (infusion bottle, airway needle, giving set and intravenous cannula), all of which grew Acinetobacter, was replaced. Contamination of the SPPS probably occurred in the ward via a contaminated giving set and airway needle, which had been in use for one week. This case illustrates the importance of following accepted guidelines for infection control in intravenous therapy.

Acinetobacter↗
PubMed1998

Nosocomial Acinetobacter baumannii infections: microbiological and clinical epidemiology.

BACKGROUND: Acinetobacter baumannii is an important opportunistic pathogen that is rapidly evolving toward multidrug resistance and is involved in various nosocomial infections that are often severe. It is difficult to prevent A. baumannii infection because A. baumannii is ubiquitous and the epidemiology of the infections it causes is complex. OBJECTIVE: To study the epidemiology of A. baumannii infections and assess the relation between fluoroquinolone use and the persistence of multidrug-resistant clones. DESIGN: Three case-control studies and a retrospective cohort study. SETTING: A 20-bed medical and surgical intensive care unit. PATIENTS: Acinetobacter baumannii was isolated from 45 patients in urine (31%), the lower respiratory tract (26.7%), wounds (17.8%), blood (11.1%), skin (6.7%), cerebrospinal fluid (4.4%), and sinus specimens (2.2%). One death was due to A. baumannii infection. MEASUREMENTS: Antimicrobial resistance pattern and molecular typing were used to characterize isolates. The incidence of A. baumannii infection and the use of fluoroquinolones were calculated annually. RESULTS: Initially, 28 patients developed A. baumannii infection. Eleven isolates had the same antimicrobial susceptibility profile, genotypic profile, or both (epidemic cases), and 17 were heterogeneous (endemic cases). A surgical procedure done in an emergency operating room was the main risk factor for epidemic cases, whereas previous receipt of a fluoroquinolone was the only risk factor for endemic cases. The opening of a new operating room combined with the restriction of fluoroquinolone use contributed to a transitory reduction in the incidence of infection. When a third epidemiologic study was done, previous receipt of a fluoroquinolone was again an independent risk factor and a parallel was seen between the amount of intravenous fluoroquinolones prescribed and the incidence of endemic infection. CONCLUSION: Epidemic infections coexisted with endemic infections favored by the selection pressure of intravenous fluoroquinolones.

Acinetobacter↗
PubMed1999

[Focus on Acinetobacter baumannii].

RESISTANCE: Acinetobacter baumannii carbapeneme-resistance is a serious problem due to the difficulty encountered in treating patients infected with this type of multiresistant bacteria. Several teams have detailed the resistance mechanisms and the way this type of strain spreads around the world. Different factors (plasmid transmission, strain variability) suggest that this type of resistance can diffuse and tends to increase with time. A NEW STRAIN: An outbreak of 15 colonizations with Acinetobacter baumannii, a BLSE producing a type PER-1 enzyme, was described in a neurosurgery intensive care unit in Great Britain. This type of strain has been exception to data and this outbreak emphasizes the problems encountered in controlling the epidemic.

Acinetobacter↗
PubMed1999

Biotyping of Acinetobacter species isolated from clinical samples.

We used the biotyping scheme using carbohydrate substrate utilization test with 14 carbon sources to speciate Acinetobacter isolates from blood and cerebrospinal fluid cultures of patients admitted to the postoperative neurosurgery ICU during January to November 1996. Sixty one patients culture positive for Acinetobacter sp. from blood or cerebrospinal fluid were followed up prospectively. Among these patients, 40 patients had clinically diagnosed infections like bacteriemia or meningitis while in 21 patients the isolation was regarded as contaminants. A. baumanniii was the most common isolate associated with clinical infections while A. lwoffii was more likely to be an environmental contaminant.

Acinetobacter↗
PubMed2000

[Outbreak of multiresistant Acinetobacter baumannii infection].

BACKGROUND: Nosocomial infections caused by multiresistant gram-negative bacteria represent an increasing problem, especially among intensive care patients. A serious outbreak of infection caused by multi-resistant Acinetobacter baumannii occurred in four burn patients. Acinetobacter is a gram-negative coccibacilli which is widespread in nature, and has been reported as an increasing problem in critically ill patients. MATERIALS AND METHODS: The outbreak strain was introduced from Alicante, Spain, by a transferred patient. This strain was resistant to all commonly available systemic antibiotics (including the karbapenems and all aminoglycosides), and sensitive only to polymyxin B. Two patients were critically ill, one of them died in septic shock. RESULTS: The ward was closed for admission of new patients and hygiene precautions were strengthened. Extensive testing of staff and equipment revealed multi-resistant A baumannii on a shower trolley shared by several patients. The outbreak strain was also identified by restriction endonuclease analysis. The patients were kept strictly isolated until their burn wounds were sufficiently healed to allow them to be discharged to their homes. INTERPRETATION: Following discharge of the last patient and extensive cleaning and disinfection of the entire ward, the particularly resistant strain has not reoccurred. Still, this experience may warrant screening for multiresistant gram-negative rods in patients transferred from regions where broad resistance to antibiotics is a common problem.

Acinetobacter↗
PubMed2002

[Nosocomial infection/colonization of the respiratory tract caused by Acinetobacter baumannii in an Internal Medicine ward].

BACKGROUND: To present the epidemiology of the outbreak and the description of patients with infection or colonization of the respiratory tract caused by A. baumannii in an Internal Medicine ward. METHODS: 20 consecutively patients hospitalized in the Internal Medicine ward were studied during 18 months with isolation of multiresistant A. baumanni in respiratory tract specimens with or without clinical signs of infection. RESULTS: Starting on an index case, that was a patient coming from other hospital with diagnosis of nosocomial Acinetobacter pneumonia, we detected 20 patients. The age of the patients ranged from 48 to 95 years, with a mean of 71.4 years. Eighty percent were males. The clinical features were similar: advanced age, with chronic diseases (35 percent diabetics, 45 percent with chronic lung diseases), and use of broad-spectrum antibiotics agents, fundamentally third generation cephalosporin (70 percent), clarithromycin (55 percent) and quinolones (30 percent). 75 percent of patients were in the same ward. Eight (40 percent) of the patients with chronic lung diseases were subjects with COPD, two with asthma and chronic glucocorticoids treatment, and one with a sleep apnea. In four cases the isolation was considered a colonization. The mean stay was 26.15 days, and the mortality 40 percent. CONCLUSIONS: The nosocomial infection caused by Acinetobacter baumannii is responsible of a high morbi-mortality between the patients hospitalized in an Internal Medicine ward, and produce an increase in length of stay. It is necessary a combination of control measures to prevent the transmission in the hospital and the outbreak of new multiresistant strains.

Acinetobacter Infections↗
PubMed2003

[Nosocomial infections caused by Acinetobacter: experience in a neonatal care unit in Casablanca].

Nosocomial infections, caused by Acinetobacter are very common in neonatal intensive care units. They are one of the major health problems. Our retrospective study report 20 cases followed in neonatology care unit of children's hospital in Casablanca from 1998 to 2000. Our aims work were to evalue the incidence and the antibioresistance and to insist for the prevention. Incidence has been estimated to 43% of nosocomial infection confirmed and 0.9% of all hospitalisations. Acinetobacter was isolated from various types of nosocomial infection septicaemia (55%), nosocomial pneumonia (30%) and meningitis (15%). The incidence of resistance was 60% for imipineme, 45% for ciprofloxacin and 30% for amikacine. This multiresistance was often responsible for failure of antibiotic therapy. Mortality was very high (55%). The prevention of nosocomial infection remains essential.

Acinetobacter↗
PubMed1992

Emergence of a multiply-resistant strain of Acinetobacter in a burns unit.

Multiply-resistant Acinetobacter has emerged as an important organism in the Burns Unit of the Singapore General Hospital. From November 1990 onwards, a strain that was resistant to all antibiotics except Polymyxin B emerged in the Burns Unit. We present two cases where the Acinetobacter isolated was resistant to all antibiotics including Polymyxin B. These cases serve as an important reminder to adhere to strict infection control procedures.

Acinetobacter↗
PubMed1992

[Identification and sensitivity of acinetobacter sp isolated from clinical specimens and hospital environment].

One hundred thirty two strains of acinetobacter isolated between october 1989 and march 1991 at the San Juan de Dios Hospital, Santiago de Chile were included in this study. One hundred twelve isolates were obtained from patients and 20 from the hospital environment. Among the 112 clinical isolates, 108 (96.4%) were identified according to the new classification proposed by Bouvet and Grimont in 1986 as A. baumannii, and four as acinetobacter genospecies 3. The 20 strains obtained from the hospital environment corresponded to A baumannii. No differences in the activities of the antimicrobial agents were found between clinical and environmental strains of A baumannii. Imipenem was the most active antimicrobial drug against A baumannii followed in descending order by sulbactam ampicillin and ceftazidime. The other antimicrobials tested showed poor activity against these strains as revealed for the MICs 50 and 90 in the resistance range.

Acinetobacter↗
PubMed2003

Acinetobacter baumannii pneumonia: a case report and review of the literature.

Bacteria that constitute the genus Acinetobacter were originally identified in the first decade of the 20th century. However, it was not until the last decade that its role as an opportunistic pathogen was fully appreciated. It is now clear that Acinetobacter is an important cause of nosocomial infection and contributes significantly to the patient's morbidity and mortality. The prevalence of infection with A. baumannii has increased significantly during the last decade. At the same time, A. baumannii has developed one of the most impressive patterns of antibiotic resistance ever observed, establishing it as an important nosocomial pathogen. It has been nicknamed the "Gram-negative MRSA" because of its frequent resistance to commonly used antibiotics. Infection with A. baumannii should be suspected in hospitalized patients who are not responding to initial empiric antibiotic treatment, and the therapeutic approach should be customized according to when the pathogen is isolated.

Acinetobacter Infections↗
PubMed2003

[Severe community-acquired Acinetobacter pneumonia].

A 62-year-old man with atrial fibrillation, hypertension, and fatty liver was admitted to a hospital in October 2002 complaining of productive cough and fever up to 38 degrees C for 2 days. He was a heavy smoker and drank alcohol regularly. He was dyspneic at rest, and chest radiography showed lobar pneumonia in the right upper lobe. Despite the administration of antibiotics, his condition deteriorated rapidly, and he was transferred to our hospital on the next day. On admission, he had multi-lobar pneumonia, septic shock, and disseminated intravascular coagulation. Despite the ventilatory support and the administration of carbapenem, macrolides, and catecholamine, he died 9 hours after admission. Later, all cultures from sputum and blood grew Acinetobacter species. Although community-acquired Acinetobacter pneumonias are rarely reported in Japan, physicians must be aware of this disease because of its fulminant clinical course and high mortality.

Acinetobacter↗
PubMed2004

Annual trends in antibiotic resistance of nosocomial Acinetobacter baumannii strains and the effect of synergistic antibiotic combinations.

Acinetobacter baumannii is becoming increasingly resistant to antibiotics often requiring combination therapy. Annual changes of resistance to selected antimicrobials of 150 A. baumannii strains, isolated as nosocomial pathogens between 1994 and 2000 were investigated. The synergistic effects of antimicrobials were studied using a microdilution checkerboard technique in eight selected isolates resistant to third-generation cephalosporins and beta-lactam/beta-lactamase inhibitor combinations and to at least one aminoglycoside. Rates of resistance of cefepime, ceftazidime, ampicillin/sulbactam, amikacin and ciprofloxacin (before 1996 and between 1996-2000) were 29.7% - 72.6, 37.8% - 81.4%, 35.1% - 72.6%, 8.1% - 56.6%, 5.4% - 46.0% respectively (p < 0.001 for each one). Synergy was observed in at least one of the combinations of antibiotics from seven of eight isolates (87%), no antagonism was detected with any combination. Ceftazidime-amikacin (50%) and ampicillin/sulbactam-tobramycin (50%) were the most effective combinations. Due to the effectiveness of sulbactams to Acinetobacter, ampicillin/sulbactam-tobramycin combination is recommended as the first line of choice.

Acinetobacter Infections↗
PubMed2003

Simplified panel of assimilation tests for identification of Acinetobacter species.

A total of 66 Acinetobacter isolates obtained from JIPMER hospital wards were subjected to phenotypic identification schemes involving 25-test and a simplified 13-test panel of carbon utilization or assimilation tests. Reference strains belonging to different DNA groups (n=24) were also tested. Identification was done using numerical approach based on a matrix constructed of phenotypic data published elsewhere and the strains were assigned to different DNA groups according to classification of Tjernberg & Ursing. Sixty-six strains tested represented 10 DNA groups in matrix of large test panel; at a probability level of 0.95. Much simplified scheme of 13 assimilation test panel failed to differentiate some isolates with in A. calcoaceticus-A. baumannii complex (Acb-complex) unlike extended panel. In all, from the large panel 95% of isolates were identified correctly among all the isolates and it did not identify 5% of isolates. From the small panel, a total of 89% of isolates were identified correctly and it could not identify 11% of isolates. Reduced number of assimilation tests to 13 from the large panel bought reduction in identification percentage rate by only 6%. It is impossible for many bacterial diagnostic labs worldwide to perform large panel of carbon utilization tests in routine practice. Simplified panel of assimilation tests suggested here seems to be the best alternative method for identification of Acinetobacter species.

Acinetobacter↗
PubMed2005

Treatment of nosocomial meningitis due to a multidrug resistant Acinetobacter baumannii with intraventricular colistin.

We report a case of serious nosocomial meningitis due to a multidrug-resistant Acinetobacter baumannii in a 23-year-old woman who had a posterior fossa craniotomy with upper cervical laminectomy for excision of a meningioma at the level of foramen magnum. Post-operatively, she had neck pain with continuous fever and deterioration in the level of consciousness and convulsions. The CSF was turbid and had neutrophil pleocytosis. A multidrug-resistant Acinetobacter baumannii was isolated from the blood and CSF. The patient failed high doses of imipenem, ciprofloxacin and systemic colistin but responded well to intraventricular injections of colistin 125,000 units twice daily for 3 weeks. No apparent side effects were noticed. We have reviewed other similar cases reported in the literature.

Acinetobacter Infections↗
PubMed2006

Infective endocarditis due to Acinetobacter baumannii complex--a case report.

We report a case of infective endocarditis caused by Acinetobacter baumannii complex in a 27-year-old male patient. The patient presented with fever of five days duration, palpitation, dyspnea, cough and chest pain. He had undergone a surgical repair of ruptured aneurysm of sinus of valsalva a month before. The transthoracic echocardiogram revealed a large vegetation on the aortic valve. Three samples of blood for culture grew gram-negative pleomorphic coccobacilli within 24 hours which were identified by cultural and biochemical characteristics to be Acinetobacter baumannii complex. Antimicrobial susceptibility was performed by Kirby-Bauer method and the isolate were found to be resistant to ampicillin, Ciprofloxacin, Ceftriaxone, Gentamicin, Amikacin, Augmentin, Levofloxacin, Piperacillin-Tazobactam, Netilimicin and sensitive to Imipenem. Patient was initially treated with Ceftraixone and Gentamicin and subsequently with Ampicillin and Amikacin but did not respond to treatment and died of sepsis before therapy with Imipenem could be started.

Acinetobacter Infections↗
PubMedDate not supplied

[Acinetobacter in a metropolitan neonatal unit: clinical and microbiological aspects].

Acinetobacter calcoaceticus var. anitratus (ACA) was isolated from two newborn infants and var. Iwoffi of the same species from a third patient within a month in the neonatal unit of a general hospital at Metropolitan Santiago, Chile. The first isolate was obtained from a neonate with infection of the skin surrounding a colostomy operation after surgery for tracheo esophageal fistulae, in march 1989. The second case's skin became colonized after he was admitted for surgical repair of severe gastroesophageal reflux into the same ward room and nursed in proximity to the first case, making necessary the use of antibiotic prophylaxis with sulbactam-ampicillin prior to surgery. The third case, a very immature female baby, was born at the same month; she had early septicaemia due to Acinetobacter calcoaceticus var. Iwoffi sensitive to gentamicin and after appropriate treatment her clinical recovery was uneventful. In the microbiological study of the neonatal unit this last microorganism was isolated from thermometers of the nursery and on the hands of one member of the nursing staff, while ACA had been reported at the preceding month from operating rooms and anesthesia equipment. Intensive surveillance of ward's environment, equipment and personnel, barrier precautions, and improved staff handwashing were then instituted and extension of an outbreak was thus avoided.

Acinetobacter↗