Journal
CLINICAL MICROBIOLOGY REVIEWS
Volume 30, Issue 1, Pages 409-447Publisher
AMER SOC MICROBIOLOGY
DOI: 10.1128/CMR.00058-16
Keywords
Acinetobacter; Acinetobacter baumannii; Acinetobacter calcoaceticus
Categories
Funding
- NIAID [R01s AI081719, AI117211, R42 AI106375, R21 AI127954, R01s AI063517, R01AI100560, UM1AI104681]
- Eisai, Inc.
- Veterans Affairs Merit Review [1I01BX001974]
- Geriatric Research Education and Clinical Center VISN
- Cempra
- Medicines Company
- MedImmune/AstraZeneca
- PTC Therapeutics
- Entasis
- Tetraphase
- Merck
- Genentech
- Dipexium
- AstraZeneca
- Melinta
- Steris
- NIH
- Veterans Affairs Merit Review
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [UM1AI104681, R21AI127954, R01AI117211, R01AI063517, R01AI103342, R01AI100560, R42AI106375, R01AI081719] Funding Source: NIH RePORTER
- Veterans Affairs [I01BX001974] Funding Source: NIH RePORTER
Ask authors/readers for more resources
Acinetobacter is a complex genus, and historically, there has been confusion about the existence of multiple species. The species commonly cause nosocomial infections, predominantly aspiration pneumonia and catheter-associated bacteremia, but can also cause soft tissue and urinary tract infections. Community-acquired infections by Acinetobacter spp. are increasingly reported. Transmission of Acinetobacter and subsequent disease is facilitated by the organism's environmental tenacity, resistance to desiccation, and evasion of host immunity. The virulence properties demonstrated by Acinetobacter spp. primarily stem from evasion of rapid clearance by the innate immune system, effectively enabling high bacterial density that triggers lipopolysaccharide (LPS)-Toll-like receptor 4 (TLR4)-mediated sepsis. Capsular polysaccharide is a critical virulence factor that enables immune evasion, while LPS triggers septic shock. However, the primary driver of clinical outcome is antibiotic resistance. Administration of initially effective therapy is key to improving survival, reducing 30-day mortality threefold. Regrettably, due to the high frequency of this organism having an extreme drug resistance (XDR) phenotype, early initiation of effective therapy is a major clinical challenge. Given its high rate of antibiotic resistance and abysmal outcomes (up to 70% mortality rate from infections caused by XDR strains in some case series), new preventative and therapeutic options for Acinetobacter spp. are desperately needed.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available