infectious diseases
Acinetobacter Infections
Diseases Caused byAcinetobacter
Themost common manifestationsofAcinetobacterdisease are Respiratory infections AB infections typically occur in critically ill, hospitalized patients. Community-acquired infections (mostly pneumonia) are more common in tropical climates. Case fatality rates associated withA. baumannii(AB) infection are 19 to 54%. Acinetobactercan cause community-acquired bronchiolitis and tracheobronchitis in healthy children and tracheobronchitis in immunocompromised adults.Acinetobactereasily colonize tracheostomy sites. Hospital-acquiredAcinetobacterpneumonias are frequently multilobar and complicated. Secondary bacteremia and septic shock are associated with a poor prognosis. Acinetobacterspecies can also cause wound infections and suppurative infections (eg, abscesses) in any organ system, including the lungs, urinary tract, skin, and soft tissues; bacteremia may occur. Rarely, these organisms cause meningitis (primarily after neurosurgical procedures), cellulitis, or phlebitis in patients with an indwelling venous catheter; ocular infections; native or prosthetic valve endocarditis; osteomyelitis; septic arthritis; or pancreatic and liver abscesses. The significance ofAcinetobacterisolates from clinical specimens, such as respiratory secretions from intubated patients or specimens from open wounds, is difficult to determine because they often represent colonization. infection depend on the type of infection (hospital-acquired, community-acquired, multidrug resistant—see table Risk Factors for Acinetobacter Infection ). Recently, multidrug-resistant (MDR) AB has emerged, particularly in intensive care units (ICUs) in immunosuppressed patients, patients with serious underlying disorders, and patients treated with broad-spectrum antibiotics after an invasive procedure. Spread in ICUs has been attributed to colonized health care practitioners, contaminated common equipment, and contaminated parenteral nutrition solutions. Also, the number of multidrug-resistant AB infections has increased in service members who were injured and treated in Iraq, Kuwait, and Afghanistan. 