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[Bacteremia with Acinetobacter species--clinicopathological characteristics of 27 cases]
1First Department of Internal Medicine, Nihon University School of Medicine.
Abstract:
Acinetobacter spp. are non-fermented gram-negative rods that are widespread in the environment and colonize in the human skin. They are known to be a nosocomial pathogen causing, pneumonia, meningitis and bacteremia. Recently, they have been found increasingly in catheter-related infections (CRI). Thirty-seven cases of bacteremia were developed in our hospital during the past five years. Of these 27 cases were chosen out of the medical records for discussion in this paper. Twenty-three cases are blood positive for Acinetobacter anitratus and 4 cases for A. lwoffii. Most cases have an underlying disease like hematological malignancy, solid tumor and infantile congenital abnormality. There were also some clinical signs; high fever, hypotension, tachycardia, tachypnea, peripheral cyanosis. A central venus catheter was inserted in 22 cases, and in 13 of these, the catheter was removed after the bacteremic episode. Nine cases became afebrile after the removal of the catheter and A. anitratus was isolated from the catheter tip in four cases. Heparin was administered through the catheter in 7 cases. Formerly Acinetobacter spp. were not recognized as a major pathogen, but recently found increasingly in CRI. We also found 9 cases which were definitely diagnosed or suspected as CRI, and were successfully treated by removal of the central venus catheter. Association between administration of heparin and bacteremia of Acinetobacter spp. was reported, we actually detected such association in 7 cases, but the potential role of heparin has not been clarified yet. Compared with A. lwoffii, A. anitratus were resistant to many drugs, but had good susceptibility to imipenem, minocycline, aminoglycoside, and fluoroquinolone.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Acinetobacter bacteremia, particularly Acinetobacter anitratus, is increasingly linked to central venous catheters (CVCs). Removal of CVCs proved effective in treating these serious nosocomial infections.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Context:
- Acinetobacter spp. are gram-negative rods found in the environment and on human skin.
- These bacteria are recognized as significant nosocomial pathogens, causing pneumonia, meningitis, and bacteremia.
- Recently, Acinetobacter spp. have emerged as a growing cause of catheter-related infections (CRIs).
Purpose:
- To analyze cases of Acinetobacter bacteremia in a hospital setting over five years.
- To investigate the association between central venous catheters (CVCs) and Acinetobacter bacteremia.
- To evaluate treatment outcomes, particularly the role of catheter removal.
Summary:
- A review of 27 cases of Acinetobacter bacteremia identified Acinetobacter anitratus in 23 cases and Acinetobacter lwoffii in 4 cases.
- Underlying conditions such as hematological malignancy and solid tumors were common.
- Central venous catheters were present in 22 cases, and removal of the CVC led to resolution of bacteremia in 9 cases.
Impact:
- This study highlights the increasing threat of Acinetobacter spp. in catheter-related infections.
- Successful treatment of CRIs was achieved through CVC removal, suggesting its importance in management.
- A potential association between heparin administration and Acinetobacter bacteremia was observed but requires further investigation.