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PubMed2003

Coaggregation between Acinetobacter johnsonii S35 and Microbacterium esteraromaticum strains isolated from sewage activated sludge.

The extent and nature of intergeneric coaggregations among non-flocculating sludge bacteria were studied through examination of the coaggregation abilities of Acinetobacter johnsonii S35 with two other strains of non-flocculating sludge bacteria (Microbacterium esteraromaticum S38 and M. esteraromaticum S51). At first, the effect of electrolyte concentration as well as the addition of EDTA and proteases on coaggregation were studied. Changes in electrolyte concentration had little effect on the aggregation index (A.I.). However, the A.I. was reduced by 35-45% (addition of 2 mM EDTA) and 15-58% (addition of 0.2 mg/ml Actinase E) within 1 h depending upon the bacterial pair involved. Furthermore, the effect of pretreating either A. johnsonii S35 or its partners with Actinase E and periodate, respectively, was studied. The results indicate that these coaggregations involve a protein on the partner's surface that may interact with carbohydrate or a carbohydrate-containing moiety on the surface of A. johnsonii S35.

Journal Article↗
PubMed2005

The potential benefit of 5% Sulfamylon Solution in the treatment of Acinetobacter baumannii-contaminated traumatic war wounds.

BACKGROUND: The recent report of high numbers of Acinetobacter baumannii bloodstream infections among service members injured in Iraq and Afghanistan during the period January 2002 through August 2004 has prompted an investigation into their etiology. A review of the current guidelines for open combat casualty wounds as part of this broad investigation was not mentioned in the report. OBJECTIVE: The objective of this study was 2-fold: to ascertain the susceptibility of A. baumannii to currently available topical antibacterial agents and (2) to propose an alternative, effective treatment protocol for contaminated combat-related wounds so as to reduce or eliminate the likelihood of the wound serving as the source of A. baumannii infection or septicemia. METHODS: A standardized antimicrobial susceptibility study of 43 strains of A. baumannii collected from a tertiary care burn center was conducted using 2 commonly used topical antibacterial agents, 1% silver sulfadiazine cream (Silvadene) and 5% mafenide acetate solution (5% Sulfamylon Solution). RESULTS: Both were effective, but 5% Sulfamylon Solution demonstrated significantly greater antibacterial activity. CONCLUSION: Five percent Sulfamylon Solution, initially developed for wartime use, and currently limited by the Food and Drug Administration to soaks following meshed split-thickness autografts following excision of second-degree and third-degree burns, has a broad spectrum of antibacterial activity and extensive off-label applicability. It is an ideal agent for use in the treatment of war wounds, and should be considered as a superior replacement for normal saline in the current guidelines for open combat casualty wounds.

Journal Article↗
PubMed2003

Nosocomial bacteremia involving Acinetobacter baumannii in critically ill patients: a matched cohort study.

OBJECTIVE: To determine outcome and attributable mortality in critically ill patients with nosocomial bacteremia involving A. baumannii. DESIGN: A retrospective matched cohort study in which all ICU patients with microbiologically documented A. baumannii bacteremia were defined as cases. Matching of the controls was based on equivalent APACHE II score (+/-2 points) and diagnostic category. Control patients were required to have an ICU stay equivalent to or longer than the case prior to onset of the bacteremia. SETTING: The 54-bed ICU of the 1060-bed Ghent University Hospital. PATIENTS: 45 ICU patients with A. baumannii bacteremia and 90 matched control subjects without clinical or microbiological evidence of blood stream infection. MEASUREMENTS: Population characteristics and in-hospital mortality rates of patients with A. baumannii bacteremia and their controls were compared. Attributable mortality is determined by subtracting the crude mortality rate of the controls from the crude mortality rate of the cases. RESULTS: Patients with A. baumannii bacteremia had significantly more hemodynamic instability, longer ICU stay, and longer length of ventilator dependence than controls. In-hospital mortality rates for cases and controls were, respectively, 42.2% and 34.4%; thus the attributable mortality was 7.8%. CONCLUSION: In critically ill patients A. baumannii bacteremia is not associated with a significantly increased mortality rate.

Acinetobacter↗