Treatment of multidrug resistant Acinetobacter
Clinton K Murray1, Duane R Hospenthal
1Infectious Disease Service, Department of Medicine, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234, USA. Clinton.Murray@amedd.army.mil
Current Opinion in Infectious Diseases
|November 1, 2005
Summary
Acinetobacter baumannii-calcoaceticus complex infections require prompt treatment with effective antimicrobials. Strict infection control is crucial to prevent colonization and manage this significant nosocomial pathogen.
Area of Science:
- Infectious Diseases
- Microbiology
- Critical Care Medicine
Background:
- Acinetobacter baumannii-calcoaceticus complex is a major nosocomial pathogen.
- It exhibits significant persistence in hospital settings and broad antimicrobial resistance.
- This necessitates a review of current clinical management strategies.
Purpose of the Study:
- To summarize recent literature on the clinical management of Acinetobacter baumannii-calcoaceticus complex infections.
- To emphasize in-vitro antimicrobial resistance patterns.
- To review antimicrobial efficacy in both animal models and human patients.
Main Methods:
- Literature review of recent studies.
- Analysis of in-vitro antimicrobial resistance data.
- Evaluation of clinical outcomes and treatment efficacy.
Main Results:
- While associated with mortality, it primarily affects high-risk patients.
- In-vitro susceptibility testing can yield conflicting results.
- Agents like imipenem/cilastatin, amikacin, ampicillin/sulbactam, colistin, rifampin, and tetracyclines show typical activity.
- Optimal therapy (monotherapy vs. combination) and management of pan-resistant cases remain unclear.
- Preventing initial colonization through infection control is a primary goal.
Conclusions:
- Acinetobacter baumannii-calcoaceticus complex remains a significant healthcare concern.
- Prompt, adequate therapy targeting susceptible strains is essential once infection is confirmed.
- Aggressive infection control policies are vital upon identification of this pathogen.
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