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Hospital infection with Acinetobacter spp.: an increasing problem
E Bergogne-Bérézin1, M L Joly-Guillou
1Department of Microbiology, Bichat University-Hospital, Paris, France.
Abstract:
During the last few years, among nosocomial pathogens, Acinetobacter spp. have given rise to an increasing number of nosocomial infections. Acinetobacter strains are widely distributed in nature; in hospitals, the human skin is the likely source for most outbreaks of hospital infections. The organism has been frequently found in the inanimate environment, especially in moist situations and it has been isolated from various types of opportunistic infections (septicaemia, endocarditis, meningitis, pneumonia, skin and wound sepsis and urinary tract infection). For epidemiological studies, various typing methods such as biotyping, bacteriocin typing and serology have been developed. More recently electrophoretic patterns of cell-envelope proteins and plasmid analysis have proved useful in differentiating outbreak strains. Antibiogram typing may be useful but the antibiotic resistance of Acinetobacter spp. has changed rapidly within the last few years and thus antibiotyping must be complemented by other typing systems. New methods such as electrophoretic analysis of isoenzymes, definition of plasmidotype profiles or restriction endonuclease digestion of chromosomal DNA are under investigation.
Insights
Acinetobacter species are increasingly causing hospital-acquired infections, often originating from human skin or moist environments. Advanced typing methods beyond simple antibiotic resistance patterns are crucial for tracking these resilient pathogens.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Acinetobacter species are significant nosocomial pathogens causing diverse opportunistic infections.
- Hospital outbreaks are frequently linked to Acinetobacter strains originating from human skin and moist environmental sources.
Purpose of the Study:
- To review current and emerging methods for the epidemiological typing of Acinetobacter strains.
- To highlight the challenges posed by rapidly evolving antibiotic resistance in Acinetobacter species.
Main Methods:
- Review of established typing techniques including biotyping, bacteriocin typing, and serology.
- Evaluation of more recent methods like cell-envelope protein electrophoresis and plasmid analysis.
- Discussion of novel techniques under investigation, such as isoenzyme analysis and DNA restriction endonuclease digestion.
Main Results:
- Traditional typing methods have limitations due to the adaptability of Acinetobacter.
- Electrophoretic and plasmid-based analyses show promise for differentiating outbreak strains.
- Antibiotic resistance patterns change rapidly, necessitating complementary typing strategies.
Conclusions:
- Effective epidemiological surveillance of Acinetobacter requires a combination of advanced molecular typing methods.
- Ongoing research into novel techniques is essential for accurate strain differentiation and outbreak control.
- Understanding transmission routes, including environmental and skin carriage, is key to managing Acinetobacter infections.