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Multiresistant Acinetobacter baumannii infections: epidemiology and management
José Garnacho-Montero1, Rosario Amaya-Villar
1Critical Care and Emergency Department, Intensive Care Unit, Virgen del Rocío University Hospital, Seville, Spain. jose.garnacho.sspa@juntadeandalucia.es
Current Opinion in Infectious Diseases
|June 29, 2010
Summary
Multidrug-resistant Acinetobacter baumannii causes severe hospital infections. Colistin and tigecycline show promise as treatment options when other antibiotics fail.
Area of Science:
- Infectious Diseases
- Microbiology
- Antimicrobial Resistance
Background:
- Acinetobacter baumannii is a significant pathogen in healthcare-associated infections.
- Multidrug-resistant strains are increasingly prevalent, often exhibiting resistance to carbapenems and other beta-lactams.
- Sulbactam, while having bactericidal activity, is frequently ineffective against these resistant strains.
Purpose of the Study:
- To review current data on the epidemiology of Acinetobacter baumannii in hospital settings.
- To discuss major resistance mechanisms employed by Acinetobacter baumannii.
- To explore therapeutic strategies for infections caused by multidrug-resistant strains.
Main Methods:
- Literature review of recent data on Acinetobacter baumannii epidemiology.
- Analysis of antimicrobial resistance mechanisms.
- Evaluation of therapeutic options for multidrug-resistant infections.
Main Results:
- Acinetobacter baumannii is a leading cause of healthcare-associated infections, frequently resistant to multiple antibiotics, including carbapenems.
- Rifampicin shows efficacy in animal models but is unsuitable for monotherapy due to rapid resistance development.
- Colistin demonstrates excellent in vitro activity and efficacy in serious infections with an acceptable safety profile.
- Tigecycline is a potential option, though more clinical data, especially for pulmonary infections, are needed.
Conclusions:
- Optimal treatment for multidrug-resistant Acinetobacter baumannii nosocomial infections remains undetermined.
- Carbapenems are standard for susceptible isolates.
- Colistin and tigecycline offer valuable therapeutic choices due to their retained in vitro activity.
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