Acinetobacter sp. can cause purulent infections in any organ system; these bacteria often make opportunistic pathogens are in hospitalized patients.
(See Introduction to Neisseriaceae.)
Acinetobacter sp. can cause purulent infections in any organ system; these bacteria often make opportunistic pathogens in hospitalized patients. (See Introduction to Neisseriaceae.) Acinetobacter are gram-negative aerobic rods belonging to the family Neisseriaceae. They are ubiquitously occurring and can survive a month on dry surfaces for up and are often worn on the skin of health workers, increasing the likelihood that patients colonized and medical devices are contaminated. There are many types of Acinetobacter. All can cause disease in humans, but A. baumannii (AB) account for about 80% of infections. Acinetobacter caused diseases The most common manifestations of Acinetobacter diseases are respiratory infections AB infections usually occur in critically ill, hospitalized patients. Community-acquired infections (mostly pneumonia) are common in tropical climates. The rough associated with AB infection mortality rate is 19-54%. The most common place for infection are the respiratory system. Acinetobacter can rapidly colonize tracheostoma and cause community-acquired bronchiolitis and tracheobronchitis in healthy children and tracheobronchitis in immunocompromised adults. Nosocomial Acinetobacter pneumonia are often multilobär and go with medical complications. A secondary bacteremia and septic shock are associated with a poor prognosis. Acinetobacter sp can also cause purulent infections (eg abscesses.) In any organ, including the lungs, urinary tract, skin and soft tissues; bacteremia may occur. Rarely these pathogens meningitis caused (especially after neurosurgery), cellulitis or phlebitis in patients with Venenverweilkathetern, ocular infections, native and Kunstklappenendokarditiden, osteomyelitis, septic arthritis or pancreas and liver abscesses. The clinical significance of isolates from clinical materials such as respiratory secretions of intubated patients or samples from open wounds is often difficult to assess because these are often only an expression of colonization. Risk Factors The risk factors for Acinetobacter infection depend on the type of infection (hospital-acquired, community-acquired, MDR-see-dependent see table: risk factors for Acinetobacter infection). Risk factors for Acinetobacter infection type of infection risk factors in hospital-acquired Fecal colonization with Acinetobacter stay in the ICU catheter length of hospital stay Mechanical ventilation Parenteral Nutrition Past infection Surgical interventions Treatment with broad-spectrum antibiotics wounds Community-acquired Alcoholism Cigarette smoking Chronic lung disease diabetes mellitus stay in a tropical developing country Multi-drug resistant Exposure to populated or infected patients Invasive procedures mechanical ventilation, particularly when long-term prolonged hospitalization (particularly in the ICU) preservation of blood products, use of broad-spectrum antibiotics (eg. B. cephalosporins third generation, carbapenems, fluoroquinolones) drug resistance Recently, a multi-drug resistant (MDR) AB emerged, especially in intensive care units in immunocompromised patients, patients with serious underlying medical conditions and patients who are treated by an invasive procedure with broad-spectrum antibiotics , The spread in intensive care units has been associated with colonized healthcare workers, contaminated shared objects and contaminated nutritional solutions. Typically therapy empirical multidrug therapy for serious infections in patients with localized cellulite or phlebitis due to a foreign body (eg. B. IV catheter, suture materials) usually enough to remove the foreign body plus a local skin care. Tracheobronchitis after endotracheal intubation can regress only by lung lavage. Patients with more extensive infections should be treated as needed with antibiotics and debridement. AB long had an intrinsic resistance to many antibiotics. MDR-AB are defined as strains which are resistant to ? 3 classes of antibiotics, some isolates are resistant to all. Before the sensitivity results are available, including carbapenem (z. B. meropenem, imipenem, doripenem), colistin, or a fluoroquinolone plus an aminoglycoside, rifampin, or both about the possible initial options. Sulbactam (a beta-lactamase inhibitor) has an intrinsic bactericidal activity against many MDR-AB strains. Tigezyklin, a Glycylzyklin antibiotic is also effective, but a borderline activity and the emergence of resistance during therapy were documented. Minocycline has in vitro activity. Mild to moderate infections may respond to monotherapy. Traumatic wound infections can be treated with minocycline. Serious infections are treated with the combination therapy-typically imipenem or ampicillin / sulbactam plus an aminoglycoside. To prevent spread, professionals should adhere to healthcare precautions (handwashing, barrier precautions) and the ventilators for patients who are colonized with MDR-AB infected adequately maintain and clean. Important points A. baumannii (AB) is responsible for about 80% of infections and tends to occur in critically ill, hospitalized patients. The most common site of infection, the respiratory tract, but Acinetobacter sp can also cause suppurative infections in any organ system. Multidrug-resistant AB has become a problem; treatment with more substances is selected as a function of the sensitivity test.