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Rapid and Specific Detection of Acinetobacter baumannii Infections Using a Recombinase Polymerase Amplification/Cas12a-based System
Published on: April 25, 2025
Severe community-acquired Acinetobacter baumannii pneumonia: an emerging highly lethal infectious disease in the
Catherine W M Ong1, David C B Lye, Kay Leong Khoo
1Division of Infectious Disease, Department of Medicine, National University Health System, Singapore 119074. c.ong09@imperial.ac.uk
Background And Objective:
Patients with community-acquired Acinetobacter baumannii (AB) pneumonia have been reported from subtropical countries. We investigated the epidemiology, clinical and microbiological characteristics of community-acquired pneumonia (CAP) due to AB in Singapore.
Method:
A retrospective case series was performed over a 21-month period at two institutions.
Results:
From 1 January 2007 to 30 September 2008, eight patients were diagnosed with CAP due to AB. Seven had bacteraemia and five were sputum culture-positive. The median age at presentation was 58.5 years (range 45-76 years). Five patients (71.4%) acquired the pneumonia in the warmer months of June to September. Presentation was acute, with a median duration of 2.5 days (range 1-7 days). The median Acute Physiology and Chronic Health Evaluation II score was 28.5 (range 6-36). Six patients presented with septic shock, lactic acidosis, acute kidney injury and respiratory failure, necessitating ICU care; five of these patients eventually died. All patients received empirical antibiotics, including third-generation cephalosporins, which were inactive against the organism. All isolates were susceptible to ampicillin/sulbactam, ciprofloxacin, co-trimoxazole, aminoglycosides and imipenem.
Conclusions:
Community-acquired AB pneumonia have a fulminant course. In a region endemic for melioidosis and severe community-acquired Klebsiella pneumoniae, the challenge lies in rapid identification and initiation of appropriate empirical antibiotics to improve the survival of patients with AB CAP.
Insights
Community-acquired Acinetobacter baumannii pneumonia is severe and often fatal, particularly in tropical regions. Rapid diagnosis and appropriate antibiotics are crucial for improving patient survival rates.
Area of Science:
- Infectious Diseases
- Microbiology
- Critical Care Medicine
Background:
- Investigating the epidemiology and clinical characteristics of community-acquired pneumonia (CAP) caused by Acinetobacter baumannii (AB) in Singapore.
- AB pneumonia is increasingly reported in subtropical regions, necessitating local data.
Observation:
- A retrospective case series identified eight patients with CAP due to AB over 21 months.
- Patients were older, with acute presentations, often severe, requiring intensive care.
- Common complications included septic shock, acute kidney injury, and respiratory failure.
Findings:
- Five patients (71.4%) acquired pneumonia during warmer months (June-September).
- Empirical third-generation cephalosporins were ineffective; however, isolates were susceptible to ampicillin/sulbactam, ciprofloxacin, co-trimoxazole, aminoglycosides, and imipenem.
- Mortality was high, with five of six ICU patients dying.
Implications:
- Community-acquired AB pneumonia follows a fulminant course.
- Rapid identification and appropriate empirical antibiotic therapy are critical for improving survival in regions endemic for melioidosis and severe Klebsiella pneumoniae.
- This highlights the need for updated empirical antibiotic guidelines for CAP in Singapore.
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