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

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. 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 Are the Types of Acinetobacter?

• There are more than 50 species of Acinetobacter bacteria, with Acinetobacter baumannii causing approximately 80 percent of reported infections in humans.

• Other common types include Acinetobacter calcoaceticus and Acinetobacter lwoffii.

• These bacteria have been found in various sources, such as vegetables, dairy products, meat, livestock, and human skin, indicating multiple routes of human exposure.

• Acinetobacter strains, including those mentioned above, demonstrate strong antibiotic resistance.

What Is the Epidemiology Behind Acinetobacter Infection?

Acinetobacter became clinically significant in the 1960s as intensive care units (ICUs) in hospitals began to grow rapidly. Although Acinetobacter is not highly virulent, its ability to survive drying out and persist in the environment for extended periods makes it easily spread in healthcare settings. Transmission often occurs through healthcare personnel, respiratory equipment like ventilators, and other medical devices. It can be present in various bodily secretions, including wounds, saliva, urine, and blood.

Despite its low virulence, Acinetobacter can still cause infections in patients with febrile neutropenia and those who have undergone organ transplants. Acinetobacter has been identified in wounds sustained by soldiers returning from combat in some countries.

What Are the Causes and Risk Factors of 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.

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 groups 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.

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,

• Fever.

• Vomiting.

• Confusion.

• Chills.

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 to 40 days to exhibit the signs of infection. 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.

How Is Acinetobacter Infection Diagnosed?

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

• 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.

• 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.

• 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 antibiotic therapy, the patients are provided with supportive care, including taking pain medications and fever medicines to subside pain and fever if present.

How Can Acinetobacter Infection Be Prevented?

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 an antibiotic, continue taking it for the entire length of time as suggested by the doctor. Even if one feels better or the illness has subsided, do not stop the course of antibiotics in between.

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

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

4. Disinfecting the Hospital Rooms: When staying in a hospital, ensure that the 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.

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.