Multidrug-Resistant Acinetobacter baumannii

Abstract

Acinetobacter baumannii is an important pathogen worldwide. This organism is becoming resistant to numerous antimicrobial agents, and it has inherent characteristics that make it highly transmissible and virulent. Although this pathogen has been well known in Europe and the Middle East, it has garnered increasing attention in the United States more recently as a cause of infections in US military personnel returning from combat. A. baumannii was the 10th most frequent cause of nosocomial bacteremia in US hospitals according to data from a prospective, nationwide surveillance study conducted from 1995 to 2002. Nonetheless, many US physicians are not aware of its virulence and transmissibility or its ability to cause large outbreaks. This clinical vignette describes the first case of multidrug-resistant A. baumannii complex (sensitive only to colisitin and high-dose ampicillin-sulbactam) isolated at our institution. The vignette also reviews the epidemiology of A. baumannii, risk factors for infection, susceptibility to antimicrobial agents, treatment options, and infection prevention and control practices necessary to prevent transmission of this pathogen.