Infections Due to Acinetobacter baumannii in the ICU: Treatment Options Journal Article

Authors: Lynch, J. P., 3rd; Zhanel, G. G.; Clark, N. M.
Article Title: Infections Due to Acinetobacter baumannii in the ICU: Treatment Options
Abstract: Bacteria within the genus Acinetobacter (principally A. baumannii-calcoaceticus complex [ABC]) are gram-negative coccobacilli that may cause nosocomial infections in critically ill or debilitated patients (particularly ventilator-associated pneumonia and infections of the bloodstream, urinary tract, and wounds). Treatment of Acinetobacter infections is difficult, as Acinetobacter spp. are intrinsically resistant to multiple antimicrobial agents, and have a remarkable ability to acquire new resistance determinants via mechanisms that include plasmids, transposons, integrons, and resistance islands. Since the 1990s, global resistance to antimicrobials has escalated dramatically among ABC. Global spread of multidrug-resistant (MDR)-A. baumannii strains reflects dissemination of a few clones between hospitals, geographic regions, and continents; excessive use of antibiotics amplifies this spread. Many isolates are resistant to all antimicrobials except colistin (polymyxin E) and tigecycline, and some infections are untreatable with existing antimicrobial agents. Antimicrobial resistance poses a serious threat to treat or prevent infections due to ABC. Strategies to curtail environmental colonization with MDR-ABD will require aggressive infection control efforts and cohorting of infected patients. Thoughtful antibiotic strategies are essential to limit the spread of MDR-ABC. Optimal therapy will likely require combination antimicrobial therapy of existing antibiotics as well as development of novel antibiotic classes.
Keywords: Infectious Diseases
Journal Title: Seminars in respiratory and critical care medicine
Volume: 38
Issue: 3
ISSN: 1098-9048; 1069-3424
Publisher: USA  
Journal Place: United States
Date Published: 2017
Start Page: 311
End Page: 325
Language: eng
Notes: LR: 20170604; CI: Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001; JID: 9431858; ppublish