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Preventing & Treating Acinetobacter Baumannii Infection

Instructor: Jason Lulejian

Jason has taught medicine and has a Medical Degree from Western University of Health Sciences

In this lesson, you will learn the basics of the bacteria Acinetobacter Baumannii. We'll cover the effects of infection by this antibiotic-resistant bacteria, as well as its prevention and treatment.

What is Acinetobacter baumannii?

Usually when we get sick with a bacterial infection, we go to the doctor, receive antibiotics, and quickly get better. But if the bacteria becomes resistant to our medicines, treatment becomes a real challenge. Such is the case with Acinetobacter baumannii.

Acinetobacter baumannii is a small, rod-shaped, opportunistic bacteria. This pathogen generally affects people with compromised immune systems, especially those in hospital settings like intensive care units. This bacteria, like many other species, has become increasingly resistant to all forms of antibiotics.

Virulence factors are factors that make some bacteria harmful, neutral, or even beneficial (in the case of probiotics) to humans. A. baumannii has several methods that it uses to be an effective pathogen. It has:

  • beta-lactamase, an enzyme that breaks down penicillin.
  • resistance islands, genes that encode more enzymes to block other classes of antibiotics.
  • biofilm formation, a sort of protective covering that makes antibiotics unable to get into the bacteria.

These mechanisms all contribute to a bacteria's ability to protect itself from antibiotics and even the patient's own immune system.

Effect of A. baumannii

Full infections are rare in healthy people. Nevertheless, A. baumannii can still colonize a healthy person, though they show no symptoms. People who are asymptotically colonized are called carriers, as they can spread it to others. This primarily occurs in person-to-person contact (physically touching) or through contaminated surfaces in a hospital. Additionally, these bacteria can live on a person's skin, and even in a clean environment (such as a clean counter top) for many days before dying.

Acinetobacter baumannii causes many ailments, including:

  • infection of the blood (sepsis),
  • infection of the skin and muscle,
  • pneumonia,
  • meningitis, and even
  • urinary tract infection.

The bacteria made a large resurgence in the early Iraq war. Many soldiers injured in Afghanistan and the Iraq/Kuwait region showed A. baumannii infections in their bloodstreams, and returning soldiers showed debilitating soft tissue infections.

With such an antibiotic-resistant threat, prevention may be the best strategy. So how can we prevent such bacteria from taking hold in our hospitals and infirmaries?

Prevention

Wash Your Hands

The key to reducing A. baumannii infections is to control contact with patients using hand hygiene. Hand hygiene has been shown in many studies to be the most protective factor that any provider can do to prevent transmission of infectious agents to their patients. Simply running their hands under water and with a small amount of soap can vastly decrease the risk of transmission. This tactic has shown marked drops in infection rates since the early 19th century.

Environmental Cleansing

The next most logical and effective method is environmental cleansing, which takes the form of sterilizing surfaces and equipment. High-grade cleaning agents such as bleach can destroy the outer coating (known as the capsule) of the bacteria. However, to truly sterilize equipment like surgical instruments, high pressure and heat are needed. Some guidelines recommend even using gamma radiation in order to guarantee the sterility of such instruments.

But what happens when prevention fails?

Treatment

The treatment of A. baumannii is fairly difficult and depends on where the infection is taking place: the blood, urine , lungs, or soft tissues of the body. Determining what antibiotics to use can be done from a pathology lab using a sample of the infection. Hospitals carry metrics known as antibiograms, which catalog all the bacteria samples and their resistance patterns. This can be very helpful in picking the best antibiotic for a particular infection when a sample can't be sent to the lab.

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