What is Acinetobacter (a type of bacteria)?

From the Guidelines

Treatment of Acinetobacter infections should be guided by susceptibility testing, and the most effective antibiotics include carbapenems, polymyxins, and sulbactam, with combination therapy considered for severe and high-risk infections. According to the most recent and highest quality study 1, the recommended treatment options for infections due to carbapenem-resistant Acinetobacter baumannii include colistin, imipenem/cilastatin, and meropenem, with adjunctive colistin inhalation considered for pneumonia. The study also suggests that sulbactam, tigecycline, and combination therapy with two in vitro active antibiotics may be considered as alternative treatments. It is essential to note that the choice of antibiotic treatment should be based on the susceptibility pattern of the isolate, and combination therapy should be considered for severe and high-risk infections. Infection control measures, including contact precautions, environmental cleaning, and hand hygiene, are crucial to prevent the spread of Acinetobacter infections. Some key points to consider when treating Acinetobacter infections include:

• Susceptibility testing to guide antibiotic therapy
• Use of carbapenems, polymyxins, and sulbactam as first-line treatments
• Consideration of combination therapy for severe and high-risk infections
• Importance of infection control measures to prevent the spread of infection
• Use of adjunctive colistin inhalation for pneumonia
• Consideration of alternative treatments, such as sulbactam and tigecycline, based on susceptibility patterns. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guidelines 1 also support the use of carbapenems, polymyxins, and sulbactam as first-line treatments for Acinetobacter infections, and recommend against the use of cefiderocol for the treatment of infections caused by carbapenem-resistant Acinetobacter baumannii. Overall, the treatment of Acinetobacter infections requires a comprehensive approach that includes susceptibility testing, appropriate antibiotic therapy, and infection control measures to prevent the spread of infection and improve patient outcomes.

From the Research

Overview of Acinetobacter

• Acinetobacter baumannii is a major cause of healthcare-associated infections, often presenting resistance to multiple antimicrobial agents 2.
• It is considered a multidrug-resistant (MDR) or pandrug-resistant (PDR) bacterium, causing infections such as bacteremia, pneumonia, meningitis, and urinary tract infections 2.

Treatment of Acinetobacter Infections

• Effective antibiotics against A. baumannii include carbapenems, polymyxins, sulbactam, piperacillin/tazobactam, tigecycline, and aminoglycosides 2.
• Carbapenems are the mainstay of treatment, but carbapenem-resistant strains have been increasingly reported worldwide 2.
• Combination therapy, such as imipenem with colistin or meropenem with sulbactam and colistin, has shown synergistic effects against MDR A. baumannii 3.
• The use of β-lactamase inhibitors, such as LN-1-255, can restore the efficacy of β-lactams against Acinetobacter spp. 4.

Challenges and Future Directions

• The increasing rates of antimicrobial resistance in Acinetobacter spp. pose a significant challenge for treatment 5.
• New solutions, such as the development of new antibiotics or the use of combination therapy, are needed to combat the detrimental effects of antimicrobial resistance 5, 6.
• Well-designed clinical studies are necessary to guide clinicians on the best therapeutic approach for patients with MDR A. baumannii infections 2.