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Acinetobacter Infection - Causes, Symptoms, Risk Factors, Diagnosis and Treatment

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Acinetobacter infection is an opportunistic infection most commonly acquired from hospitals. Read this article to know more about this infection.

Medically reviewed by

Dr. Pandian. P

Published At March 22, 2022
Reviewed AtFebruary 22, 2023

What Is Acinetobacter Infection?

Acinetobacter infection is caused by a group of bacteria that belong to the genus Acinetobacter. These bacteria survive in damp and moist areas like ponds, seawater, mud, fish farms, wastewater, soils, and wetlands. An essential point of concern that alarms medical professionals is that these bacteria have a broad spectrum of antibiotic resistance, that is, they are resistant to most antibiotics.

How Common Is Acinetobacter Infection?

According to the antibiotic resistance (AR) threat reports of the United States, around 8500 hospitalized patients developed Acinetobacter infection, of which 700 individuals lost their lives.

What Causes Acinetobacter Infection?

Acinetobacter infection is caused by a bacterial group that belongs to the genus 'Acinetobacter.' There are different types of Acinetobacter bacteria, and the commonly responsible bacteria for causing human infections is the Acinetobacter baumannii. In addition to this, Acinetobacter lwoffii and Acinetobacter calcoaceticus can cause illness in humans. These bacteria develop resistance to antibiotics, meaning that the antibiotics do not destroy them. These bacteria can either be single-drug-resistant or multidrug-resistant. Carbapenem-resistant Acinetobacter is an example of a multidrug-resistant bacteria.

What Are the Symptoms of Acinetobacter Infection?

Acinetobacter infections are nosocomial (hospital-acquired) or community-acquired infections. They can occur in the lungs, blood, urinary tract, or areas of skin where there is an open wound.

The following are the different types of infections and their manifestations:

In the wounds, Acinetobacter infection causes:

  • Pain and redness around the wound.

  • Pus discharge.

  • Fever.

Acinetobacter enters the bloodstream and produces,

Respiratory tract manifestations of Acinetobacter infection are,

  • Fever.

  • Chills.

  • Persistent cough.

In the urinary tract, Acinetobacter infection causes,

  • Frequent urination.

  • Blood in the urine.

  • Passage of cloudy urine.

  • Urine with a foul smell.

  • Pain and burning sensation while urinating.

How Long Does Acinetobacter Infection Take to Produce Symptoms?

Despite their ability to cause infections, these bacteria can also stay asymptomatic in a patient. The most common sites where these bacteria may remain asymptomatic are either open wounds or secretions of the respiratory tract.

When it produces symptoms, it can take about four days to 40 days to exhibit the signs of infections. However, it has been reported that almost all infections start showing symptoms within 12 days.

How Is Acinetobacter Infection Transmitted?

Acinetobacter bacteria can live on surfaces and equipment in hospitals and other healthcare settings like ventilators, catheters, etc. Intensive care units (ICU) have reported the highest number of cases of Acinetobacter infection.

From these sites, the Acinetobacter bacteria can be transmitted in one of the following ways:

  1. Spread from one person to another through contaminated hands.

  2. Spread from one person to another by touching the surfaces that have been contaminated or by using contaminated equipment.

What Increases the Risk of Acinetobacter Infection?

Since these infections are mainly nosocomial, people who stay at hospitals for prolonged periods or require more hospital equipment that can harbor the bacteria are at an increased risk.

The following are the group of people who share an increased risk of contracting Acinetobacter infection:

  • Patients in intensive care units (ICU).

  • Patients on catheters and ventilators.

  • Patients who are staying for an extended period in the hospital.

  • Patients with postoperative open wounds.

  • Immunocompromised individuals.

  • Patients with chronic respiratory tract dysfunctions.

  • Diabetic individuals.

How Is Acinetobacter Infection Diagnosed?

The following are the diagnostic tests employed in the diagnosis of Acinetobacter infection:

  1. Culture Test: A culture test is performed by taking urine, blood, or tissue samples from the affected individual depending on the type of infection. These tests help diagnose the type of organism responsible for the infection and choose the right antibiotic.

  2. Chest X-Ray: In order to check for respiratory infections, a chest X-ray is taken. It helps identify pneumonia and other infections present in the lungs or heart.

  3. Lumbar Puncture: A needle is inserted into the spinal cord, and a sample is taken from the lumbar region, which helps in identifying spinal cord infections, bleeding, or other problems present in and around the spinal cord.

How Is Acinetobacter Infection Treated?

  • Antibiotic Therapy: Like any other bacterial infection, Acinetobacter infections are treated with antibiotics. However, since these bacteria are resistant to many antibiotics, the type of antibiotic that can be used to treat these infections is identified with the help of culture tests. In these culture tests, the antibiotic effectiveness against these bacteria is determined based on the antibiotic activity, drug interactions, and adverse effects.

  • Supportive Care: In addition to the antibiotic therapy, the patients are provided supportive care, including taking pain medications and fever medicines to subside pain and fever if present.

How Can I Prevent Acinetobacter Infection?

The following are the preventive measures to avoid Acinetobacter infection:

1. Avoiding the Misuse of Antibiotics: Do not consume antibiotics without the advice of the doctor. If a doctor has prescribed you an antibiotic, continue it for the entire length of time as suggested by your doctor. Even if you feel better or your illness has subsided, do not stop the course of antibiotics in between.

2. Maintain Personal Hygiene: Follow respiratory etiquette by sneezing or coughing into your bent elbow or tissue. Properly dispose of the tissue. Wash your hands with soap and water thoroughly after sneezing or coughing, after using the bathroom, before eating, or before touching food. When in places of no water, use a good alcohol sanitizer to wash your hands.

3. Wound Management: Do not keep any wounds open. Clean the wound adequately and cover them with a bandage until it is sufficiently healed.

4. Disinfecting the Hospital Rooms: When staying in a hospital, ensure your room is cleaned daily with EPA (environmental protection agency) - registered chemical disinfectants like peracetic acid, quaternary ammonium, hypochlorite, phenolics, and accelerated hydrogen peroxide, and the equipment and devices used are adequately sterilized or new.

prevention of acinetobacter infection

Conclusion:

Acinetobacter bacteria cause Acinetobacter infections with antibiotic resistance. Since these are primarily hospital-acquired, proper contamination procedures are essential for controlling these infections in hospital settings. In addition, individuals should avoid the misuse of antibiotic drugs to prevent these infections.

Frequently Asked Questions

1.

What Do Acinetobacter Infections Refer To?

Acinetobacter is a group of common bacteria present in the environment, soil, and water. Although many species of the genus exist, Acinetobacter baumannii accounts for most Acinetobacter infections in humans. The bacteria cause blood, urinary, and lung infections. The bacteria have been found to form colonies within humans, especially in sputum and open wounds, without causing infections.

2.

Is It Possible to Cure Acinetobacter?

Acinetobacter has a tendency to develop drug resistance. Beta-lactam antibiotics are the preferred treatment of choice. However, the resistance rates for beta-lactam and Carbapenems are increasing dramatically. Acinetobacter is usually sensitive to Meropenem, Colistin, Polymyxin B, Amikacin, Rifampin, Minocycline, and Tigecycline. The overall prognosis depends on the underlying health conditions and the extent of organ damage.

3.

How Does Acinetobacter Spread?

Acinetobacter can survive for extended periods on external surfaces. The bacteria spread from person to person through shared equipment, contact with contaminated surfaces, and contaminated hands. Within healthcare setups, Acinetobacter may spread from healthcare workers’ hands and contaminated surfaces or medical equipment.

4.

Can One Die Off Acinetobacter?

Acinetobacter bacteria have been involved in infections with increased mortality rates. According to a few studies, mortality rates of patients with Acinetobacter infection are reported between 26 to 56 percent. The high mortality rates may be attributed to the tendency of Acinetobacter to develop multi-drug resistance.

5.

Which Antibiotics Are Fatal to Acinetobacter?

Traditionally, beta-lactam and Carbapenems antibiotics were used against Acinetobacter, but of late, there has been a dramatic rise in drug resistance against the antibiotics. Acinetobacter is reportedly sensitive to Meropenem, Colistin, Polymyxin B, Amikacin, Rifampin, Minocycline, and Tigecycline antibiotics.

6.

How Long Does Acinetobacter Treatment Last?

Over the last few years, there has been a dramatic rise in multi-drug-resistant Acinetobacter bacteria. Due to the rise of such strains, management has been particularly difficult and more complicated. Depending on the patient’s health and illness, antibiotic therapy may be continued for seven to ten days.

7.

Should an Acinetobacter Patient Be Put In Isolation?

The recommendation for Acinetobacter isolation widely varies. Some studies suggest that isolation is not necessary; rather infection control measures are to be implemented as Acinetobacter can also survive as a commensal bacteria. Other studies have suggested that patients are supposed to be isolated in private rooms with one-to-one nursing.

8.

What Are the Precautions to Be Taken Against Acinetobacter?

Some of the precautionary measures for patients and caregivers include:
- Keeping hands clean and using soap and water and alcohol-based sanitizers.
- Hand hygiene protocols before wound care or handling medical devices.
- Clean the room daily in a healthcare setting.
- Prevent sharing of instruments.

9.

What Is the Significance of Acinetobacter in Urine Culture?

Acinetobacter may survive as a commensal bacteria but may even cause a range of infections in various organs. It is not uncommon for Acinetobacter to precipitate UTIs (urinary tract infections). The symptoms of Acinetobacter-associated UTIs include frequent urination, pain or burning during urination, blood in the urine, cloudy or foul-smelling urine, and altered mental status. The bacteria may be found in the culture of urine samples, which indicates the presence and active infection.

10.

Is It Possible to Treat Acinetobacter Pneumonia?

Due to the rising trend of multidrug antibiotic resistance of Acinetobacter bacteria, it has been increasingly complicated and difficult to manage and treat the infections. Any Acinetobacter infection, including Acinetobacter pneumonia, can be treated with a combination of various antibiotics. Bacterial culture may be first necessary to determine the resistances and sensitivities of the bacteria to various antibiotics or their combination. The treatment may last up to ten days.

11.

Is Acinetobacter a Part of Normal Flora?

Acinetobacter may survive as a commensal bacteria but is not part of the normal human microbiome of either the skin or the gut. However, the bacteria, according to a few studies, may be commonly found on the skin of humans. Usually, the bacteria are widely found in the soil and water and perform a key step of mineralization in the soil.

12.

How Long Does Acinetobacter Survive on Surfaces?

The mean survival period of Acinetobacter bacteria was about 27.29 days, while the mean survival time of outbreak stains was 26.55 days. According to a laboratory study, Acinetobacter survived for six days on dry filter paper, 13 days on formica, seven days on glass, and more than 25 days on cotton.

13.

Can One Be Vaccinated Against Acinetobacter?

Vaccines are one of the most effective preventive measures against multi-drug resistant Acinetobacter. Several live, outer-membrane-based, DNA (deoxyribonucleic acid), and glycoconjugate vaccines are under development. None of these vaccines are in clinical trials but have shown positive results in animal studies.

14.

Is It Possible to Get Sepsis From Acinetobacter?

Acinetobacter bacteria have been isolated from wounds, which shows its potential to colonize in wounds. The multi-drug resistant pathogen is among the most prevalent ones associated with trauma wounds and blood infections. Septic shock and disseminated intravascular coagulation are serious complications of the infection. Sepsis is a highly fatal complication in patients in the intensive care unit.
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Dr. Pandian. P
Dr. Pandian. P

General Surgery

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