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Acinetobacter – the Bad, the Awful, and the Downright Ugly

So, Why is CRAB so Hard to Treat? First, A. baumannii is intrinsically resistant to penicillins, ampicillin, amoxicillin-clavulanate, 1st and 2nd generation cephalosporins, cephamycins, aztreonam, ertapenem, macrolides, and more; therefore, treatment options are few. Second, it has an “unrivaled adaptive nature,” to cite one source – due to a “plethora of mechanisms,” including a predilection for developing heteroresistance, and an ability to acquire (by plasmid or transposon) resistance markers.

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Articles of Interest

Pan-resistant?? The rise of Acinetobacter

In the all-star annals of resistant bugs, A. baumanii is an underappreciated player. If people – other than, you know, disease geeks – recognize it, that is because it's become known in the past few years for its propensity to attack wounded veterans shipped to military hospitals from Iraq and Afghanistan, earning it the nickname "Iraqibacter."

'My husband squeezed my hand to say he wanted to live, then I found a way to save him'

When Tom Patterson started vomiting during an Egyptian holiday he thought he had food poisoning. He was wrong. In fact he was infected with an antibiotic-resistant superbug and only his wife's determination and a revolutionary new treatment would save him. Tom was the first person in North America to receive intravenous phage therapy to treat a systematic superbug infection. Steffanie recognises how lucky they were, and how much depended on her connections, which enabled her to launch the international effort to save her husband.

Acinetobacter Baumannii Infections Among Military Patients

Acinetobacter baumannii is a well known but relatively uncommon cause of health-care--associated infections. Because the organism has developed substantial antimicrobial resistance, treatment of infections attributed to A. baumannii has become increasingly difficult.

Another resistant bug rising: Acinetobacter

Because MRSA is a Gram-positive, we don't talk much here about the Gram-negatives — the two categories of bacteria have different cell-wall structures and thus are treated using different categories of drugs. (That structural difference causes them to react in different ways to a stain invented by a scientist named Gram in the 19th century.) But the resistance situation with Gram-negatives is at least as dire as with MRSA, possible more so, because there are fewer new drugs for Gram-negatives in the pharmacology pipeline (as discussed in a New Yorker article by Dr. Jerome Groopman last year.)

Antibiotic resistance doesn’t just make bacteria harder to kill – it can actually make them stronger

We looked at another multidrug and even pan-drug antibiotic resistance organism called Acinetobacter baumannii, which causes many types of severe infections in the lungs, blood and skin, and a non-drug-resistant bacterium, Vibrio cholerae, which causes cholera. V. cholera also has some natural antibiotic resistance genes. Along with coauthors Drs John Mekalanos and Stephen Lory at Harvard Medical School, we found that for A. baumannii and V. cholerae, the loss of antibiotic resistance was associated with loss of fitness and a weakened ability to cause infection. But, when the bacteria acquired antibiotic resistance through a genetic mutation, they became more virulent

Carbapenem-resistant Acinetobacter baumannii (CRAB): An urgent public health threat in United States healthcare facilities

Carbapenem-resistant Acinetobacter baumannii (CRAB) are bacteria resistant to nearly all antibiotics and difficult to remove from the environment. As a result, CRAB can cause deadly infections and large outbreaks among hospitalized patients and nursing home residents. Although all CRAB pose a risk to patients, some CRAB can carry genes that enable the bacteria to make carbapenemase enzymes that destroy carbapenem antibiotics. These carbapenemase genes can move among bacteria, increasing the likelihood that multidrug resistance will spread. Resistance to carbapenems further reduces patient treatment options.

Hospital superbug uses tiny sticky fingers to infect medical tools and devices

The antibiotic-resistant Acinetobacter baumannii bacterium is one of the most globally harmful bacteria that causes nosocomial infections. Researchers have discovered that the bacterium attaches to plastic medical devices using tiny finger-like structures. The researchers were able to develop antibodies that prevent the bacterial spread.

In Blitz to Kill One Kind of Infectious Bacteria, Other Untreatable Strains Emerge

Gram-negative bacteria like acinetobacter are thriving in clinical environments, causing infections that are currently untreatable with any conventional drugs.

Multidrug Resistant Acinetobacter

Emergence and spread of Acinetobacter species, resistant to most of the available antimicrobial agents, is an area of great concern. It is now being frequently associated with healthcare associated infections.

The antibiotic arms race moves at high speed

Acinetobacter baumannii is a pathogen that creates serious problems in hospitals throughout the world. It causes opportunistic infections in the bloodstream, urinary tract, and other soft tissues, accounting for as much as 20 percent of infections spread in Intensive Care Units. As one of the pathogens involved in many multidrug-resistant infections caught in hospitals, it was top of the highest priority "Critical" group of antibiotic-resistant pathogens the World Health Organization rated in 2017 as needing further research.

The Invisible Enemy

In the taxonomy of bad bugs, acinetobacter is classified as an opportunistic pathogen. Healthy people can carry the bacteria on their skin with no ill effects – a process known as colonization. But in newborns, the elderly, burn victims, patients with depressed immune systems, and those on ventilators, acinetobacter infections can kill. The removal of Gadsden's spleen and the traumatic nature of his wounds made him a prime target.

The Iraq Infection

Doctors worry not only about soldiers who are already infected but also those who are carrying Acinetobacter on their skin even though they themselves are not infected.

You Better Hope Science Finds a Way to Kill These Super Bacteria

The three most critical bacteria, if you're collecting their trading cards, are Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae (which includes bugs you've probably heard of like Salmonella and E. coli). All three are resistant to powerful carbapenem antibiotics, which are considered the last line of treatment to stop an infection. The Enterobacteriaceae are also resistant to the newest generation of cephalosporin antibiotics.

Resources

Center for Innovative Phage Applications and Therapeutics

Center for Innovative Phage Applications and Therapeutics We are the first dedicated phage therapy center in North America, bringing innovative research and clinical practice to the field of medicine. Join us on our journey and witness a revolutionary wave of solutions to combat antibiotic resistance.

The 12 most dangerous superbugs, ranked by the WHO

The 12 bugs on the list are classified as critical, high and medium priority. At the top of the critical category are Acinetobacter baumannii and Pseudomonas aeruginosa, which can cause deadly blood infections and pneumonia, most commonly in hospital patients. The third on the list, carbapenem-resistant enterobacteriaceae, is a family of germs that include Klebsiella and E. coli bacteria. They also commonly originate in hospitals, and can lead to urinary tract infections, bloodstream infections, and pneumonia with high mortality rates.