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Acinetobacter infection: Epidemiology, microbiology, pathogenesis, clinical features, and diagnosis

Authors
Zeina A Kanafani, MD, MS
Souha S Kanj, MD
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Allyson Bloom, MD

INTRODUCTION

Acinetobacter is a gram-negative coccobacillus that has emerged from an organism of questionable pathogenicity to an infectious agent of importance to hospitals worldwide [1]. The organism has the ability to accumulate diverse mechanisms of resistance, leading to the emergence of strains that are resistant to all commercially-available antibiotics [2].

The microbiology, pathogenesis, epidemiology, and disease associations of Acinetobacter infection will be reviewed here. The treatment and prevention of Acinetobacter infection are discussed separately. (See "Acinetobacter infection: Treatment and prevention".)

EPIDEMIOLOGY

The epidemiology of Acinetobacter infections is broad and includes infection associated with tropical environments, wars and natural disasters, and hospital outbreaks in temperate climates [3-7]. It naturally inhabits water and soil, and other possible reservoirs include pets, arthropods, and food animals [5,8-10]. In humans, Acinetobacter can colonize skin, wounds, and the respiratory and gastrointestinal tracts [11]. It can also inhabit oral biofilms, predisposing to pneumonia in the event of aspiration into the lower respiratory tract [12,13].

Some Acinetobacter strains can survive environmental desiccation for weeks, a characteristic that promotes transmission through fomite contamination in hospitals [14-16].

Association with climate — Historically, Acinetobacter has been a pathogen of humid climates. Years before Acinetobacter became a concern in intensive care units (ICUs) in the United States, it was cited as the cause of 17 percent of cases of ventilator-associated pneumonias in a Guatemalan ICU, second only to Pseudomonas, which caused 19 percent of cases [17].

                 

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