Acinetobacter Pneumonia: A Review

Joshua D. Hartzell, MD, Andrew S. Kim, MD, Mark G. Kortepeter, MD, MPH, Kimberly A. Moran, MD

In This Article

Abstract and Introduction

Disclaimer: The views expressed are those of the authors and should not be construed to represent the positions of Walter Reed Army Medical Center, the Department of the Army, or the Department of Defense.

Acinetobacter species are becoming a major cause of nosocomial infections, including hospital-acquired and ventilator-associated pneumonia. Acinetobacter species have become increasingly resistant to antibiotics over the past several years and currently present a significant challenge in treating these infections. Physicians now rely on older agents, such as polymyxins (colistin), for treatment. This paper reviews the epidemiology, treatment, and prevention of this emerging pathogen.

Pneumonia caused by Acinetobacter species can present major challenges for physicians. Outbreaks of Acinetobacter infection, including pneumonia, have occurred in healthcare facilities worldwide, including military treatment facilities caring for troops serving in Southwest Asia in support of Operation Iraqi Freedom (OIF) and in Afghanistan in support of Operation Enduring Freedom (OEF).[1,2,3,4,5,6,7,8,9,10,11,12,13,14]Acinetobacter species were responsible for 6% of cases of ventilator-associated pneumonia between 1992 and 1997 in the United States.[15] According to National Nosocomial Infections Surveillance data, Acinetobacter species caused 7% of intensive care unit (ICU) nosocomial cases of pneumonia in 2003 compared with 4% in 1986.[16] Community-acquired Acinetobacter pneumonia can also occur among certain at-risk populations. Of growing concern is the increase in multidrug resistance exhibited by clinically relevant species. Physicians are now relying on such antibiotics as the polymyxins (colistin) for treatment. In this article, we will review the epidemiology, treatment, and prevention of this emerging pathogen, with a focus on Acinetobacter pneumonia.

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