Acinetobacter baumani - MegaMicro

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Acinetobacter baumani

Microbiology > Bacteriology > Gram-negative bacteria > Gram-negative bacilli
Acinetobacter baumannii complex

Structure:  Strictly aerobic, non-lactose fermenting, oxidase negative, Gram negative coccobacillus.  Over 30 species have been identified; however, only 5 are associated with human disease, the majority by Acinetobacter baumannii.

Epidemiology:
• Reservoir: naturally inhabits soil and water; colonizes skin, wounds, respiratory and GI tracts.  
• Most particularly involved in hospital-associated (HA) infections in debilitated patients in ICU as well as infections associated with natural disasters and wars.
• Some strains can survive environmental desiccation for weeks, contributing to their ability to create outbreaks via contaminated fomites.

Pathobiology:
• Virulence factors: biofilm formation enhanced by the presence of pili, biofilm-associated protein (Bap) and outer membrane protein A (OmpA).
• K1 capsule present in approximately one-third of the strains; delays complement activation and phagocytosis.

Disease Manifestations:
• Particularly noted for Hospital-aquired, ventilator-associated pneumonia and central-line associated bacteremia.  
• Also involved in indwelling-catheter urinary tract infections, burn, surgical and traumatic wound infections.

Laboratory diagnosis:
• Bacterial culture: readily grows on routine culture media.
• Send sputum, blood, body fluid, wound and tissue samples as appropriate.

Differential diagnosis: Other bacterial Hosptital aquired infections

Treatment:
• Increasingly difficult to treat with the emergence of multi-drug resistant (MDR) strains.  Specific therapy should be guided by the in vitro susceptibility test results.
• Antibiotic susceptible strains:  ceftazidime or cefepime, a carbapenem or ampicillin-sulbactam.
• Antibiotic resistant strains:  polymyxins (polymyxin B or colistin), minocycline or tigecycline.

Prevention and control:
• Strict adherence to infection control protocols, hand hygiene and disinfection practices to prevent environmental contamination and patient to patient transmission.
• Limit use of broad-spectrum antibiotics.

Related concepts
Gram negative bacteria, Acinetobacter, ventilator-associated pneumonia, central-line infections
 
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