As a healthcare-associated infection, Acinetobacter baumannii is becoming a more serious influence as antibiotic resistances rates rise, and policy must encourage strict hygeine compliance and careful drug choice to prevent major outbreaks in the future, according to a Review released on November 18, the The Lancet Infectious Diseases.
According to author Professor Matthew E Falagas and Dr Drosos Karageorgopoulos, Alfa Institute of Biomedical Sciences, Athens, Greece, there are many environmental sources for Acinetobacter baumannii: soil; foods like vegetables, meat, and fish; and occasionally, the skin of healthy people. However, true infections of A. baumannii are usually only found in critically ill, hospitalized patients. Risk factors for infection include advanced age, serious co-morbidities or underlying diseases, immune suppression, major trauma or burns, invasive procedures (including indwelling catheters), support via mechanical ventilation, an extended hospital stay, and previous administration of a course of antibiotics.
Over the last three decades, new infections with A. baumannii have increased substantially, a change the authors potentially attribute to the availability of advanced medical support for critically ill patients, creating a larger vulnerably sub-population. It is also increasingly reported in the victims of war conflicts or mass destruction.
Recently, multidrug resistance in A. baumannii has been reported as 30%. While carbapenem antibiotics are usually considered standard treatment for such infection, as resistance rates rise, alternatives must be found. Most recently, sulbactam has been adopted, but this method is becoming less effective over time. Polymyxins are a promising new group which have recently surfaced in this struggle; also, minocycline and its derivative tigecycline, may have potential in this field. Ultimately, future therapies must be confirmed with further research.
Health care facilities around the world are suffering from issues related to antibiotic resistance rates in various pathogens. One well-known example of an antibiotic resistant pathogen is methicillin-resistant Staphylococcus aureus (MRSA). Due to continued interest in this public health problem, The Lancet Infectious Diseases will host a conference on healthcare-associated infections between December 11 and 12 in London, which will feature international experts in the field.
John McConnell, editor of The Lancet Infectious Diseases, notes the importance of this issues to today’s public health: “Modern medicine faces few greater challenges than that of healthcare-associated infections (HAIs). In the UK, one of the worst-affected countries in Europe, HAIs are estimated to cost the National Health Service at least £1 billion [1.5 billion USD] per year. Media attention has increased public pressure to tackle HAIs — a pressure that clinicians, researchers, and policy makers must deal with. The conference programme has been designed to combine state-of-the-art lectures with the opportunity for delegates to discuss management of HAIs with key opinion leaders.”
Current control and treatment of multidrug-resistant Acinetobacter baumannii infections
Drosos E Karageorgopoulos, Matthew E Falagas
Lancet Infect Dis 2008; 8: 751–62
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Written by Anna Sophia McKenney