Acinetobacter in modern warfare

Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, UK.
International journal of antimicrobial agents (Impact Factor: 4.3). 05/2012; 39(5):363-75. DOI: 10.1016/j.ijantimicag.2012.01.018
Source: PubMed


Increasing appreciation of the role of Acinetobacter baumannii in the aetiology of severe nosocomial infections, together with its ability to employ several mechanisms to rapidly develop resistance to multiple classes of antimicrobial agents, has led to growing interest in this organism over recent years. Recognition and subsequent investigation of the significance of pathogenic Acinetobacter infections in military personnel sustaining injuries during the conflicts in Afghanistan and Iraq has provided an important contribution to the epidemiology of infections with Acinetobacter spp. The following review examines this recent military experience.

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    • "Acinetobacter baumannii is considered as an emerging pathogen being reported from many regions in the world [1] [2] [3]. In addition to being one of the top three pathogens involved in hospital-acquired infections, it is also one of the mostly found colonizing pathogens in patients with burn [4] [5]. "
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    ABSTRACT: Background: Refractory carbapenem resistant Acinetobacter baumannii (CRAB) isolates increase mortality and morbidity rates among patients with underlying disorders, especially in patients with burns. The aim of the current study was to understand the resistant determinants of CRAB isolates and their clonal relatedness collected from referral Burn center. Methods: CRAB isolates were initially characterized and then antimicrobial susceptibility testing was assessed by E-test. Resistance determinants were investigated by PCR. Repetitive extragenic palindromic elements-PCR (REP-PCR) was used for clonality relatedness among isolates. Results: Thirty CRAB isolates were collected during the study. Colistin was the most effective antibiotic, but, all of the isolates were resistant to carbapenems. intI1 was detected in two isolates and MBLs and gene cassettes were not detected. ISAba1, blaOXA-51, blaOXA-23 and ISAba1/blaOXA23-like were detected in all, while blaOXA-24-like were present in 73% and blaOXA-58&OXA-143 were not present in isolates. REP-PCR demonstrated three clusters, with the dominant B cluster, which contained 16 subgroups. Conclusion: CRAB harboring ISAba1/blaOXA-23-like family is widely disseminated in the studied Burn ward setting and the emergence of infection control measures should be regarded to limit refractory CRABs.
    Full-text · Article · Jan 2015 · Burns
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    • "The 42 vaccine antigens identified in this study could feasibly be tested in a murine sepsis model to examine their ability to protect against bloodstream infections, one of the most important clinical manifestations of MDR A. baumannii [1]. A recent international surveillance study reported the association of A. baumannii with 8.8% of ICU infections (ranging from 3.7% to 19.2% according to geographical region) [36]. A. baumannii has also emerged as an important cause of infections resulting from injuries sustained by military personnel during recent operations in Iraq and Afghanistan [37]. Therefore, a broadly protective vaccine against A. baumannii may have a major impact on some high risk groups, including ICU patients, injured military personal, patients undergoing elective surgery, diabetics and hemodialysis patients. "
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    ABSTRACT: Acinetobacter baumannii is an emerging opportunistic bacterium associated with nosocomial infections in intensive care units. The alarming increase in infections caused by A. baumannii is strongly associated with enhanced resistance to antibiotics, in particular carbapenems. This, together with the lack of a licensed vaccine, has translated into significant economic, logistic and health impacts to health care facilities. In this study, we combined reverse vaccinology and proteomics to identify surface-exposed and secreted antigens from A. baumannii. Using in silico prediction tools and comparative genome analysis in combination with in vitro proteomic approaches, we identified 42 antigens that could be used as potential vaccine targets. Considering the paucity of effective antibiotics available to treat multidrug-resistant A. baumannii infections, these vaccine targets may serve as a framework for the development of a broadly protective multi-component vaccine, an outcome that would have a major impact on the burden of A. baumannii infections in intensive care units across the globe.
    Full-text · Article · Oct 2013 · PLoS ONE
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    • "Invasive procedures, such as central venous catheter and ventilator use, recent major surgery, prior antimicrobial treatment, prolonged hospitalization and prior A. baumannii colonization have been identified as risk factors for facilitating A. baumannii infections (Jang et al., 2009). Furthermore, A. baumannii has emerged as an important pathogen in military treatment facilities (O'Shea, 2012). "
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    ABSTRACT: Carbapenem resistance among Acinetobacter baumannii strains isolated from clinical settings in Brazil has increased dramatically in the last 10 years due to the emergence and dissemination of OXA-type carbapenemase encoding genes. This study aimed to characterize the presence of carbapenem-hydrolyzing class D β-lactamases (CHDL)-encoding genes and clonal complexes playing a major role in the dissemination of OXA-carbapenemase-producing A. baumannii in Southeast Brazil. A total of 74 A. baumannii strains isolated from patients admitted to 4 hospitals in Southeast Brazil were analyzed. Molecular characterization of strains revealed that sixty-seven strains carried blaOXA-23 (72%), blaOXA-143 (25%) or both genes (3%). PFGE analysis identified 12 PFGE clusters, grouping 26 pulsotypes. Two PFGE clusters were predominant, comprising more than 66% of OXA-producing A. baumannii isolates. Among 23 representative strains characterized by MLST-UO (Multilocus Sequence Typing Scheme - University of Oxford,, 14 different STs were identified, of which six were confirmed as novel sequence types (designated as STs 402 to 407). Most of these isolates belonged to clonal complexes CC104, CC109 or CC113, whereas three STs were singletons (ST339, 403 and 407). In conclusion, the presence of blaOXA-23- and blaOXA-143-like genes was not related to specific ST/CC, suggesting that the dissemination of OXA-carbapenemase-encoding genes may involve different STs, in which the spread of OXA-23-like is most likely due to mobile elements (i.e., plasmids). In this regard, CC104, CC109 and CC113 played a major role as predominant CDHL-carrying clones, instead of CC92, which was not identified.
    Full-text · Article · Jul 2013 · Infection, genetics and evolution: journal of molecular epidemiology and evolutionary genetics in infectious diseases
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